ProPublica’s James Bandler, Patricia Callahan, Sebastian Rotella and Kirsten Berg tell how the world’s greatest public health organization was brought to its knees by a virus, the president and the capitulation of its own leaders, causing damage that could last much longer than the coronavirus.
At 7:47 a.m. on the Sunday of Memorial Day weekend, Dr. Jay Butler pounded out a grim email to colleagues at the Centers for Disease Control and Prevention in Atlanta.
Butler, then the head of the agency’s coronavirus response, and his team had been trying to craft guidance to help Americans return safely to worship amid worries that two of its greatest comforts — the chanting of prayers and singing of hymns — could launch a deadly virus into the air with each breath.
The week before, the CDC had published its investigation of an outbreak at an Arkansas church that had resulted in four deaths. The agency’s scientific journal recently had detailed a superspreader event in which 52 of the 61 singers at a 2½-hour choir practice developed COVID-19. Two died.
Butler, an infectious disease specialist with more than three decades of experience, seemed the ideal person to lead the effort. Trained as one of the CDC’s elite disease detectives, he’d helped the FBI investigate the anthrax attacks, and he’d led the distribution of vaccines during the H1N1 flu pandemic when demand far outstripped supply.But days earlier, Butler and his team had suddenly found themselves on President Donald Trump’s front burner when the president began publicly agitating for churches to reopen. That Thursday, Trump had announced that the CDC would release safety guidelines for them “very soon.” He accused Democratic governors of disrespecting churches, and deemed houses of worship “essential services.”
Butler’s team rushed to finalize the guidance for churches, synagogues and mosques that Trump’s aides had shelved in April after battling the CDC over the language. In reviewing a raft of last-minute edits from the White House, Butler’s team rejected those that conflicted with CDC research, including a worrisome suggestion to delete a line that urged congregations to “consider suspending or at least decreasing” the use of choirs.
On Friday, Trump’s aides called the CDC repeatedly about the guidance, according to emails. “Why is it not up?” they demanded until it was posted on the CDC website that afternoon.
The next day, a furious call came from the office of the vice president: The White House suggestions were not optional. The CDC’s failure to use them was insubordinate, according to emails at the time.
Fifteen minutes later, one of Butler’s deputies had the agency’s text replaced with the White House version, the emails show. The danger of singing wasn’t mentioned.
Early that Sunday morning, as Americans across the country prepared excitedly to return to houses of worship, Butler, a churchgoer himself, poured his anguish and anger into an email to a few colleagues.
“I am very troubled on this Sunday morning that there will be people who will get sick and perhaps die because of what we were forced to do,” he wrote.
When the next history of the CDC is written, 2020 will emerge as perhaps the darkest chapter in its 74 years, rivaled only by its involvement in the infamous Tuskegee experiment, in which federal doctors withheld medicine from poor Black men with syphilis, then tracked their descent into blindness, insanity and death.
With more than 216,000 people dead this year, most Americans know the low points of the current chapter already. A vaunted agency that was once the global gold standard of public health has, with breathtaking speed, become a target of anger, scorn and even pity.
How could an agency that eradicated smallpox globally and wiped out polio in the United States have fallen so far?
ProPublica obtained hundreds of emails and other internal government documents and interviewed more than 30 CDC employees, contractors and Trump administration officials who witnessed or were involved in key moments of the crisis. Although news organizations around the world have chronicled the CDC’s stumbles in real time, ProPublica’s reporting affords the most comprehensive inside look at the escalating tensions, paranoia and pained discussions that unfolded behind the walls of CDC’s Atlanta headquarters. And it sheds new light on the botched COVID-19 tests, the unprecedented political interference in public health policy, and the capitulations of some of the world’s top public health leaders.
Senior CDC staff describe waging battles that are as much about protecting science from the White House as protecting the public from COVID-19. It is a war that they have, more often than not, lost.
Employees spoke openly about their “hill to die on” — the political interference that would prompt them to leave. Yet again and again, they surrendered and did as they were told. It wasn’t just worries over paying mortgages or forfeiting the prestige of the job. Many feared that if they left and spoke out, the White House would stop consulting the CDC at all, and would push through even more dangerous policies.
To some veteran scientists, this acquiescence was the real sign that the CDC had lost its way. One scientist swore repeatedly in an interview and said, “The cowardice and the caving are disgusting to me.”
Collectively, the interviews and documents show an insular, rigorous agency colliding head-on with an administration desperate to preserve the impression that it had the pandemic under control.
Some of the key wounds were self-inflicted. Records obtained by ProPublica detail for the first time the cataclysmic chain of mistakes and disputes inside the CDC labs making the first U.S. test for COVID-19. A respected lab scientist made a fateful decision to use a process that risked contamination, saw signs of trouble, but sent the tests to public health labs anyway. Many of those tests didn’t work, and the scramble to fix them had serious consequences.
Even when the CDC was not to blame, the Trump administration exploited events to take control of the agency’s messaging. As a historically lethal pandemic raged, the White House turned the CDC into a political bludgeon to advance Trump’s agenda, alternately blocking the agency’s leaders from using their quarantine powers or forcing them to assert those powers over the objections of CDC scientists.
Once seen as an apolitical bulwark, the CDC endured meddling on multiple fronts by officials with little or no public health experience, from Trump’s daughter Ivanka to Stephen Miller, the architect of the president’s immigration crackdown. A shifting and mysterious cast of political aides and private contractors — what one scientist described as young protégés of Trump’s son-in-law, Jared Kushner, “wearing blue suits with red ties and beards” — crowded into important meetings about key policy decisions.Agency insiders lost faith that CDC director Dr. Robert Redfield, a Trump appointee who’d been at the agency only two years, would, or could, hold the line on science. One division leader refused to sign what he viewed as an ill-conceived and xenophobic Trump administration order. Redfield ultimately signed it himself.
Veteran CDC specialists with global reputations were marginalized, silenced or reassigned — often for simply doing what had always been their job. Some of the agency’s most revered scientists vanished from public view after speaking candidly about the virus.
The Trump administration is “appropriating a public enterprise and making it into an agent of propaganda for a political regime,” one CDC scientist said in an interview as events unfolded. “It’s mind-boggling in the totality of ambition to so deeply undermine what’s so vitally important to the public.”
The CDC repeatedly declined to make Butler, Redfield or any other employees mentioned in this story available for questions, and a CDC spokesperson declined to comment on behalf of the agency. The White House did not respond to an email seeking comment.
A spokesperson for the Department of Health and Human Services, which oversees the CDC, rejected accusations of political interference.
“Under President Trump, HHS has always provided public health information based on sound science,” the HHS spokesperson said. “Throughout the COVID-19 response, science and data have driven the decisions at HHS.”
People interviewed for this story asked to remain anonymous because they feared retaliation against themselves or their agency.
In interviews and internal correspondence, CDC employees recounted the stunning fall of the agency many of them had spent their careers building. Some had served on the front lines of the CDC’s most storied battles and had an earned confidence that they could swoop in and save the world from the latest plague, whether it was E. coli on a fast-food burger or Ebola in a distant land. Theirs was the model other nations copied. Their leaders were the public faces Americans turned to for the unvarnished truth. They’d served happily under Democrats and Republicans.
Now, 10 months into the crisis, many fear the CDC has lost the most important currency of public health: trust, the confidence in experts that persuades people to wear masks for the public good, to refrain from close-packed gatherings, to take a vaccine.
Dr. Martin Cetron, the agency’s veteran director of global migration and quarantine, coined a phrase years ago for what can happen when people lose confidence in the government and denial and falsehoods spread faster than disease. He called it the “bankruptcy of trust.” He’d seen it during the Ebola outbreak in Liberia in 2014, when soldiers cordoned off the frightened and angry residents of the West Point neighborhood in Monrovia, the capital. Control of a pandemic depended not just on technical expertise, he told colleagues then, but on faith in public institutions.
Today, some CDC veterans worry that it could take a generation or longer to regain that trust.
“Most of us who saw this could be retired or dead by the time that’s fully fixed,” one CDC official said.