CDC chief’s letter greenlighting Pence for debate draws criticism

In his three-paragraph letter, Redfield said he had a “detailed discussion” with Pence’s physician about the vice president’s possible exposure to “persons with COVID-19.” Based on the consultation with Pence’s doctor, Jesse Schonau, and Schonau’s “investigation and the serial negative testing results of the Vice President, the CDC concludes from a public health standpoint, it is safe for the Vice President to participate in the upcoming Vice-Presidential debate,” Redfield wrote.

It is highly unusual, and perhaps unprecedented, for the CDC director to release a letter vouching for the health of a top public official.

Based on the description of Pence’s movements provided by the vice president’s doctor, the CDC director concluded that CDC guidance calls for 14 days of isolation if there is “close contact” with someone who has covid-19. But Redfield said Pence was not a “close contact” of anyone who was infected.

The letter is raising concern within the CDC and among public health experts about the propriety of Redfield’s actions, especially after President Trump and at least nine White House employees have tested positive for the novel coronavirus. The CDC is not involved in investigating the scope and source of the outbreak linked to the White House.

“To me, if we are not involved in the investigation, I don’t know how we could make that determination” that Pence is safe to participate in the debate, said one CDC official who was upset by Redfield’s action and spoke on the condition of anonymity for fear of retaliation. “We should stick to our guidance. You should be quarantined for 14 days if exposed.”

Another agency scientist said it was inappropriate for Redfield to use his government office to clear a citizen for a political event. “Pence should have asked for a private entity to endorse he was ‘clean,’” this official said, also speaking on the condition of anonymity for fear of retaliation. “Using his special privileged access to the nation’s top public health official is disturbing.”

Other infectious-disease experts also raised concern about Pence’s status, pointing to the growing number of people who have tested positive for the virus since Trump’s diagnosis with covid-19, the illness it causes. The CDC defines a close contact as someone who was within six feet of an infected person for at least 15 minutes. Pence attended the Rose Garden ceremony two Saturdays ago marking the Supreme Court nomination of Judge Amy Coney Barrett — an event attended by several others since diagnosed with covid-19.

“We only know what we see, so we have no idea what kind of contact Pence had with all of the 14 or 15 new people that have been diagnosed in the last week,” said Rochelle Walensky, chief of the division of infectious diseases at Massachusetts General Hospital.

“From what I saw in the Rose Garden event, it did look like those chairs were closer than six feet apart, and it looked like that event lasted longer than 15 minutes, and to me it looked like he was closer than six feet to several people who had disease.

“If that is the case, he meets the CDC definition for quarantine, and there is no way according to CDC that he can ‘test’ out of it,” Walensky said.

She said the White House’s lack of transparency about the pandemic over “many months” and political interference in the CDC and the Food and Drug Administration have undermined public trust in the health agencies.

“This could represent another example of that,” she said, referring to Redfield’s letter on behalf of Pence. Many questions remain, she said, about the safety of the debate stage he will share in Salt Lake City with the Democratic vice-presidential nominee, Sen. Kamala D. Harris (D-Calif.), and about the aides and staff Pence might have contact with, including individuals Wednesday at the debate hall, on the plane and in the audience.

Redfield’s letter was the subject of debate among epidemiologists on Twitter on Tuesday and Wednesday.

Angela Rasmussen, a virologist at Columbia University’s Mailman School of Public Health, noted that Pence attended two public events with Trump after the Rose Garden ceremony, and that he said he visited Trump in the Oval Office that same day.

“Being in the same office, likely unmasked, counts as close contact,” Rasmussen wrote. “It is irresponsible for VP Pence to debate Senator Harris in person tonight, and it is unfortunate that the director of the CDC has chosen to overrule his own agency’s guidelines.”

Pence spokesman Devin O’Malley said the vice president’s physician “performed a full and robust contact-tracing effort in order to make the conclusions that were contained in his recent memos,” referring to the physician’s memos on Pence’s coronavirus test results. A memo from Schonau on Tuesday afternoon said Pence tested negative. “And those findings were presented to the CDC,” O’Malley said.

Pence’s aides say that none of the people who have tested positive — including Trump and Sen. Mike Lee (R-Utah), whom Pence was sitting near during the Sept. 26 Rose Garden event — met the CDC’s criteria for a “close contact” that would warrant a 14-day quarantine. The aides said Pence did not come within six feet of Trump, including when he met with him in the Oval Office, and Lee’s office said he did not begin showing symptoms within 48 hours of the Sept. 26 event.

White House officials presumed that lawyers at the CDC would be aware of the consultation and publication of the letter, according to a senior administration official, speaking on the condition of anonymity to talk candidly. He said the debate was not “some random political event” but an approved event. The official said he would expect the same consideration would be given to Harris and Democratic presidential candidate Joe Biden if they made similar requests of the CDC.

Redfield’s action comes as he has faced scrutiny inside the administration and from outside experts, who have watched in alarm as the CDC repeatedly changed and delayed guidelines about issues pertaining to the coronavirus because of political pressure from the White House, officials have said.

On Tuesday, concerns about Redfield’s leadership were amplified as a blistering letter addressed to Redfield last month by former CDC director William H. Foege — regarded as a giant in public health circles for his work helping to eradicate smallpox — became public. The existence of the letter was first reported by USA Today.

“You could upfront, acknowledge the tragedy of responding poorly, apologize for what has happened and your role in acquiescing,” Foege wrote to Redfield in a letter dated Sept. 23 that is being widely circulated among former CDC employees and public health physicians.

Trump has publicly undermined the CDC and Redfield personally, complaining about the agency’s guidelines for wearing masks and reopening schools. The president also excoriated Redfield’s Senate testimony that universal mask-wearing may be more useful than a coronavirus vaccine.

The White House has grown immensely frustrated with Redfield in recent months, placing his job in jeopardy, according to several current and former senior administration officials, who spoke on the condition of anonymity to discuss internal matters. They say Trump is unlikely to fire Redfield before the election because doing so would give the impression the White House response is in disarray when Trump and his top aides are trying to convey a message that the worst of the outbreak is behind the country.

After his treatment for covid-19 at Walter Reed National Military Medical Center, Trump this week tweeted: “Don’t be afraid of covid. Don’t let it dominate your life.”

White House officials view Redfield as unable to manage the 13,000-employee agency. The administration’s treatment of Redfield has dismayed outside public health experts and health officials on the White House coronavirus task force.

The Foege letter was intended to be private. He urged Redfield to openly address the administration’s political interference and to send a letter to all CDC employees “laying out the facts” and accept the political consequences.

“At the moment, they feel you accepted the White House orders without sufficient resistance,” Foege wrote. Redfield could use the moment now to “set a course for how CDC would now lead the country if there was no political interference, give them the ability to report such interference to a neutral ombudsman, and assure them that you will defend their attempts to save this country.”

“You don’t want to be seen, in the future, as forsaking your role as servant to the public in order to become a servant to a corrupt president,” Foege added.

Foege, who was awarded the Presidential Medal of Freedom in 2012 by President Barack Obama, said in the letter the White House would “of course” respond with fury, probably resulting in Redfield’s firing. Foege predicted that would be a story stretching over several weeks, bringing attention to political interference in the agency and potentially helping change the course of the pandemic.

The CDC had no immediate comment.

White House spokesman Judd Deere said: “Every decision the CDC has made under the Trump Administration has been data-driven to save lives, and this dishonest narrative that the media and Democrats have created that politics is influencing decisions is not only false but is a danger to the American public.”

Within hours of Foege’s letter becoming public, emails and text messages were lighting up the phones of staff at the CDC and elsewhere.

Many in the agency share Foege’s sentiments, one official said. “Redfield needs to push for the science and public health, and the letter really addresses the politicization of science,” said the official, who spoke on the condition of anonymity to speak frankly.

Josh Dawsey contributed to this report.

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