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Covid-19: Trump’s “distraction” by the 2020 election led to thousands of deaths, says pandemic response adviser

BMJ 2021; 375 doi: (Published 28 October 2021) Cite this as: BMJ 2021;375:n2636

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  1. Owen Dyer
  1. Montreal

Deborah Birx, who was the White House coronavirus response coordinator under President Donald Trump, has told a congressional inquiry that at least 129 000 lives could have been saved if his administration had provided adequate testing and properly communicated the gravity of the situation to the public.

But the election year “just took people’s time away and distracted them from the pandemic,” she told the House Select Subcommittee on the Coronavirus Crisis. “I felt like the White House had gotten somewhat complacent through the campaign season.”

Asked if Trump did everything he should have to counter the pandemic, she said, “No. And I’ve said that to the White House. I believe I was very clear to the president in specifics of what I needed him to do.”

“If we had fully implemented the mask mandates, the reduction in indoor dining, the getting friends and family to understand the risk of gathering in private homes, and we had increased testing, then we probably could have decreased fatalities by 30-40%.” That would amount to at least 129 000 preventable covid deaths over the course of the Trump presidency, which saw roughly 429 000 reported deaths attributed to the coronavirus.

Birx, a physician specialising in HIV/AIDS immunology, vaccine research, and global health, who previously led the president’s Emergency Plan for AIDS Relief, was one of the administration’s leading optimists in April 2020, according to White House sources reported in the media.

When Trump sought justification for what turned out to be a premature reopening of the economy, the New York Times reported, he turned to Birx, who “was a constant source of upbeat news for the president and his aides, walking the halls with charts emphasising that outbreaks were gradually easing.”1

Birx also praised Trump fulsomely at the time. “He has been so attentive to the details and the data, and his ability to analyse and integrate data has been a real benefit during these discussions,” she told the Christian Broadcasting Network in March 2020.

She drew criticism from several doctors in March 2020 for reassuring Americans that the country was not at risk of running short of ventilators. Ryan A Stanton, a board member at the American College of Emergency Physicians, compared Birx to “the builders of the Titanic saying the ship can’t sink.”

But the tone of Birx’s public warnings grew increasingly urgent as cases surged in July 2020 and, as the end of Trump’s presidency approached, she spent much of her time on the road visiting covid hotspots to encourage mask wearing and social distancing.

One reason for her estrangement from the White House, she suggested, was the growing influence of former Stanford radiologist Scott Atlas, who was brought in as an adviser after Trump saw him speak against mask mandates and social distancing on FOX News.

“I made it clear that I would not attend meetings where he would be present, to create a line in the sand,” Birx testified. “I was constantly raising the alert in the doctors’ meetings of the depth of my concern about Dr Atlas’ position, Dr Atlas’ access, Dr Atlas’ theories and hypotheses.”

She blamed Atlas for organising a meeting between Trump and three physicians who later authored the Great Barrington Declaration, a call to deliberately encourage herd immunity which drew heavy criticism from epidemiologists.2

Responding to the release of Birx’s testimony, Atlas said in a statement that she “failed to stop the dying, failed to stop the infection from spreading” in her time in the White House. “It is not a surprise that Dr Birx, as the official coordinator of the White House Coronavirus Task Force from late February 2020 through January 2021, might want to blame others for the failure of her policies,” said Atlas. “The claim that I advised the president at any point in my time in Washington to ‘let the infection spread widely without mitigation to achieve herd immunity’ is false,” he said.

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