In the last month, President Donald Trump has urged states to send children back to school, demanded governors reopen their economies, and called for lockdowns to be ended. He has pushed forward with that strategy by, in part, telling Americans that the U.S. will likely have a coronavirus vaccine in the next few months, if not sooner.
“We’re going to have a vaccine soon,” Trump said during a press conference with reporters Thursday afternoon. “It’s going to be much sooner than you think.”
But top health officials in his administration admitted this week that “there’s no way of knowing” when a vaccine will be available and that it could take another nine months to produce. On a call with the nation’s governors Wednesday, Health and Human Services Secretary Alex Azar spoke to state leaders about the constraints the U.S. faces in getting out a vaccine for public use. Azar said there are certain thresholds that clinical trials have to meet in order to convince scientists that what they are developing is working.
“When those thresholds are met, that’s when the companies and we can be unblinded to doubt. Until then, we don’t know what’s happening,” Azar said. “The Pfizer CEO said he might see data in October based on his modeling, but we don’t know. It could be October… it could be December. It depends really on how many events the unvaccinated accrue in order to demonstrate a statistically significant, different impact between being vaccinated and not being vaccinated.”
Moncef Slaoui, chief adviser of Operation Warp Speed, a public-private partnership to fast-track a vaccine, was also on the call. Slaoui, who used to head the pharmaceutical giant GlaxoSmithKline, said that when companies see the clinical trial data they will experience either a “hallelujah” or “oh my God” moment. Until that time, it is unclear when Americans might be able to get vaccinated for the virus.
The dichotomy between Trump’s messaging on the vaccine and the private doubts raised by senior health officials highlights the extent to which the administration is still, seven months into the pandemic, struggling to coordinate its response to a highly contagious virus that has killed close to 200,000 Americans. It also raises questions about how the administration will handle a possible resurgence of the virus if there are still clear divisions between how health officials are thinking about COVID-19 and how the president envisions the fight against it.
While some in the administration are actively sweating a potential second wave of the virus this fall, the man at the top has yet to show it. In recent months, President Trump has bragged to close advisers that he’s grown increasingly convinced that he and his team have done such a great job quashing the coronavirus pandemic that they likely forestalled another wave altogether, according to two people with knowledge of his private remarks.
“The president holds this up as one of his greatest accomplishments,” a senior administration official who works with the coronavirus task force said. “It is something he takes a lot of pride in… even though many of us would say the work is not done yet.”
Behind closed doors, these sources say, the president will sometimes emphasize that “many” professionals and administration brass—including White House economic adviser Larry Kudlow or Trump’s new coronavirus adviser Scott Atlas—keep reassuring him that a second wave isn’t as likely as some experts are predicting, or that another surge in infections wouldn’t even be a reason for a course-correction.
“One of the reasons he is so confident about the fall is he seems to totally believe he did everything right the first time, so if it happens again, why not continue and stay the course?” one of the knowledgeable sources said. “He has told me that nobody wants a ‘second wave’ more than the media or Democrats, who would just want to stick it to him” before the November election.
Stephen Moore, a longtime conservative economist who informally advises Trump and his team on economic and coronavirus matters, acknowledged that a second wave was a possibility. “But a second lockdown,” he said, “would be just totally unacceptable; I think that’s widely accepted on the White House economics team.”
Inside the medical community, few share Trump’s confidence. Top scientists have warned of the potential of another wave of the virus emerging during the flu season and as thousands of students continue to contract COVID-19 across the country. And they have been disheartened watching the administration seem to step back from several of the supporting roles it played in helping to combat the pandemic over the spring and summer. Indeed, despite the risk to the public in the coming months, the Trump administration is placing more responsibility on the states to take care of their people.
Last week the Federal Emergency Management Administration (FEMA) announced that it would stop reimbursing localities for things like face masks for schools and for disinfecting transportation systems. Through the Lost Wages Assistance program, FEMA was also paying millions of dollars to unemployed Americans through a grant program, but the funds are running out and FEMA has notified local communities of its plan to stop payouts.
Meanwhile, Project Airbridge—a project launched by Trump adviser and son-in-law Jared Kushner that essentially fast-tracked the delivery of essential medical supplies such as ventilators to hospitals across the country—has shuttered.
The Department of Health and Human Services, which is in charge of the government’s national strategic stockpile of medical gear, said it is still purchasing more equipment for the fall, including dialysis machines that hospitals in New York City ran out of during the early peak of the outbreak. HHS said it was “on track to achieve a 90-day goal for supplies by the fall of 2020.” However, top health officials in the administration, two of whom spoke to The Daily Beast, said there are bigger concerns—beyond whether the government has enough supplies—about whether the administration has learned from prior missteps.
For months during the pandemic, Trump undermined some of his most senior health officials, including Anthony Fauci, the nation’s top infectious-diseases expert. In July, Fauci said the U.S. was still “knee-deep” in the first wave of the coronavirus while Trump pushed the narrative that the country was in a “good place.” Trump said he disagreed with Fauci and slammed him in an interview for advising Americans not to wear a mask at the beginning of the pandemic and pushing back on Trump’s decision to ban travel from China. (Fauci originally told Americans not to wear a mask primarily because he worried about supply shortages for health-care workers. Bob Woodward reports in his new book Rage that Fauci did, in fact, support the ban even before Trump announced it.)
As coronavirus cases spiked in cities across the country this summer, Trump dismissed the advice of health officials when he pushed states to reopen their economies and then again when he put pressure on the CDC to revise and limit its school-reopening guidance. And as Trump began insisting that the rise in COVID cases was merely a byproduct of more testing, his administration’s top health officials were sounding the alarm, warning that coronavirus cases were spiking because of actual person-to-person transmission.
Officials say they are concerned the president will continue to challenge some of his health officials should another wave develop—as it likely will—and that the mixed messaging will confuse the public. But there are also worries about who will take charge.
For the first two months of the COVID pandemic, various government agencies, including CDC, HHS, and FEMA, predominantly followed the directives of Trump and worked closely with Kushner. It wasn’t clear who exactly was in charge. It wasn’t until March 18 that FEMA took over the federal response to the virus, coordinating the efforts of both the task force and HHS.
The administration is also still coming to terms with how the first wave of the coronavirus affected mortality. It’s been nine months since the global coronavirus first emerged, but the U.S. is still trying to count its dead, with local officials still scrambling to keep up.
The Centers for Disease Control and Prevention now says its data indicates that there were about 200,000 “excess deaths” during the pandemic in comparison to the same time period last year. CDC officials said about 31,000 of those deaths were not attributed to the virus and that likely thousands of the excess deaths were attributable to COVID-19. But officials working on mortality in the CDC are still trying to determine the most accurate death toll for the virus over the last seven months.
Bob Anderson, the chief of the Mortality Statistics Branch in CDC’s National Center for Health Statistics, said his office officially joined the task force in recent weeks to work with the data team—a group of statisticians and scientists trying to get a handle on the data gathered by hospitals and states on COVID-19 deaths.
“This number shows that there’s a big problem and that there may be many more deaths attributed to the coronavirus than previously understood,” said Anderson.