Dr. Anthony Fauci is, by now, a household name. But the good doctor's mostly unalloyed advocacy of scientific and public health truths has come with clear political and personal costs.
As the coronavirus has spread, Birx has hewed much closer to the White House’s often-problematic pandemic script.
There are constant rumblings of Fauci's firing by President Donald Trump, who excoriates him regularly for committing "a lot of mistakes." In addition, the director of the National Institute of Allergy and Infectious Diseases has drawn the ire and ridicule of lawmakers like Sen. Rand Paul, R-Ky., and Rep. Jim Jordan, R-Ohio, for opining on matters deemed to be beyond his preserve. Most bloodcurdling are the "serious threats" that have been made against him and his family.
Fauci's counterpart on the White House coronavirus task force, Dr. Deborah Birx, the response coordinator, is in a different position. House Speaker Nancy Pelosi called Birx "the worst" in a closed-door meeting with members of the Trump administration at the end of July. Then during a follow-up appearance on ABC's "This Week" on Aug. 2, Pelosi accused the official of enabling Trump's spread of coronavirus misinformation.
These concerns are not unfounded. As the coronavirus has spread from raging fires in scattered epicenters to a national inferno, Birx has hewed much closer to the White House's often-problematic pandemic script. For months, she stayed publicly mum in the face of Trump's politicized and patently false claims about the contagion, occasionally gushing about his nuanced appreciation for science.
Yet, when Birx finally countered some of Trump's conspiracy theories and half-truths this month, she predictably found herself in his crosshairs.
She stated the obvious last week, describing infections as "extraordinarily widespread"throughout the nation. This irked Trump, who accused Birx of taking "the bait" from Pelosi and attacking the administration's response.
Birx, a colonel in the Army who serves at the pleasure of the president, highlights the metamorphosis that seemingly competent and objective individuals undergo inside Trump's White House. As David Smith wrote in the Guardian, "Like other White House officials before her, she is said to be sacrificing a hard-won professional reputation at the altar of Trump's vanity."
Now, as America enters a new, critical coronavirus phase, Birx finds herself at a fork in the pandemic road. Will she continue to walk the line between truth and the politicized "truth" Trump desires to hear? Or will she opt to clearly put her medical oath over job security?
August would be an ideal time for Birx to grow a spine. With the protracted first wave of the virus inching closer to the dreaded fall and with schools now reopening, the country remains all but rudderless in its response to the coronavirus pandemic. After the federal government abdicated its role to helm a coordinated response, 50 states scrambled to cobble together 50 different plans.
Trump, meanwhile, has continued with his dangerous musings on the virus. As physician Dhruv Khullar observed in the New Yorker, "The work of saving lives has been complicated by misinformation, rhetoric, and political calculation." Apart from hismuddled messaging on masks, Trump has said COVID-19 would just "disappear," promoted hydroxychloroquine as a safe and effective treatment, ascribed increased cases merely to testing and pronounced 99 percent of coronavirus cases to be "totally harmless." He has also continued to peddle his belief that kids are "virtually immune" from the virus "and we have to open our schools."
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Doctors like Fauci and Birx find themselves in an unenviable position, as do so many employed by the Trump administration. They have been tasked with speaking uncomfortable and inconvenient truths to those in power. But given the current asphyxiation of scientific and public health expertise in Washington, there is little room for excuses.
Birx established her profile as a physician-scientist of great repute through work on HIV and AIDS since the 1980s. Nowadays, Birx works closely with Vice President Mike Pence, who refers to her as his "right arm." With an office located near the Situation Room, she has become a cog in the president's team.
Unfortunately, instead of serving as a firewall in the West Wing against Trump's medical disinformation, Birx has too often been obsequious.
In an interview with the Christian Broadcasting Network in March, she praised Trump's ability to assimilate data and science: "He's been so attentive to the scientific literature and the details and the data," she said, Vox reported. "I think his ability to analyze and integrate data that comes out of his long history in business has really been a real benefit during these discussions about medical issues." In April, she remained mum and unmoved when the president turned to her and hypothesized aloud about using disinfectant as a coronavirus treatment.
That same month, her rosy outlook on the country's outbreak provided Trump the scientific data he needed to push forward with his plans to reopen the country economically after an extensive lockdown. As the New York Times reported in July, "Dr. Birx was the chief evangelist for the idea that the threat from the virus was fading." Her fervor was based on her erroneous assumption that America's trajectory would resemble Italy's and that infections and deaths would crater after reaching a peak in mid-April.
Given the president's stance on the Centers for Disease Control and Prevention and school reopenings, it is unnerving that Birx has worked to strip the organization of potentially vital coronavirus patient data. She has also worked to create more pliable guidelines for schools, despite the concerns of many medial professionals.
The suddenly beleaguered Birx is not without allies, however. Even as Trump turned on her, the New York Times reported that others have spoken out in her defense, including Kentucky Gov. Andy Beshear and Gov. Tate Reeves of Mississippi. Dr. Carlos del Rio, an infectious disease specialist who helms the scientific advisory board for a State Department AIDS program Birx runs, told the New York Times it was Birx who convinced Pence to appear publicly wearing a mask, weeks before Trump relented. In the past, even Anthony Fauci has noted that Birx finds herself "in a difficult position" and that she "essentially lives in the White House."
A difficult position indeed. But as Fauci told Politico, "You should never destroy your own credibility. And you don't want to go to war with a president."
"But you got to walk the fine balance of making sure continue to tell the truth," he said.
Ultimately, the looming loss of more American lives as summer turns to fall should give Deborah Birx pause. At a moment when science and public health have been criminally devalued, fidelity to Trump — and yes, perhaps her future career prospects — should be superseded by a simple promise she made many years back as a medical student to "first, do no harm."