Health Chief’s Early Missteps Set Back Coronavirus Response

HHS Secretary Alex Azar waited for weeks to brief the president and oversold his agency’s progress

By Rebecca Ballhaus & Stephanie Armour of The WSJ. Excerpts:

"On Jan. 29, Health and Human Services Secretary Alex Azar told President Trump the coronavirus epidemic was under control.

The U.S. government had never mounted a better interagency response to a crisis, Mr. Azar told the president in a meeting held eight days after the U.S. announced its first case, according to administration officials. At the time, the administration’s focus was on containing the virus.

When other officials asked about diagnostic testing, Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, began to answer. Mr. Azar cut him off, telling the president it was “the fastest we’ve ever created a test,” the officials recalled, and that more than one million tests would be available within weeks.

That didn’t happen. The CDC began shipping tests the following week, only to discover a flaw that forced it to recall the test from state public-health laboratories. When White House advisers later in February criticized Mr. Azar for the delays caused by the recall, he lashed out at Dr. Redfield, accusing the CDC director of misleading him on the timing of a fix. “Did you lie to me?” one of the officials recalled him yelling.

Six weeks after that Jan. 29 meeting, the federal government declared a national emergency and issued guidelines that effectively closed down the country. Mr. Azar, who had been at the center of the decision-making from the outset, was eventually sidelined.

Many factors muddled the administration’s early response to the coronavirus as officials debated the severity of the threat, including comments from Mr. Trump that minimized the risk. But interviews with more than two dozen administration officials and others involved in the government’s coronavirus effort show that Mr. Azar waited for weeks to brief the president on the threat, oversold his agency’s progress in the early days and didn’t coordinate effectively across the health-care divisions under his purview.

The ramp-up of the nation’s diagnostic testing for the disease caused by coronavirus, which many health experts regard as critical for limiting new infections and safely reopening the economy, has been slower than promised and hampered by obstacles. As of Wednesday, more than four million government and private-lab tests had been administered. The president now says states bear the primary responsibility for testing, and that the federal government plays only a supporting role."

"The CDC’s Dr. Redfield alerted Mr. Azar to the coronavirus threat on Jan. 3. Mr. Azar asked the National Security Council to monitor what was happening in China, but waited two weeks to brief the president on the potential severity, calling him to assure him the agency was ready to handle any cases in the U.S."

"FDA chief Stephen Hahn asked HHS in January if he could start contacting diagnostic and pharmaceutical companies about possible shortages of personal protective gear and other equipment, administration officials said. He was told no. An FDA official said the agency was already conducting outreach to companies.

Mr. Azar told associates such calls would alarm the industry and make the administration look unprepared, people familiar with the matter said. HHS officials waited weeks to contact manufacturers about possible shortages of medical supplies, the people said."

"On Jan. 28, Mr. Azar told reporters that for the individual American, the virus “should not be an impact on their day-to-day life,” adding that the administration was taking “aggressive action.” The next day, the White House announced that Mr. Azar would lead the task force responding to coronavirus. In the task force meeting that day, he assured the president that everything was under control."

"Administration officials said they were alarmed by the absence on the task force of the FDA’s Dr. Hahn, which they said hampered coordination between the FDA and commercial labs on testing, and CMS administrator Seema Verma.

Mr. Azar dismissed those concerns, administration officials said. In the interview, Mr. Azar said the White House determined who would join the task force, and that he met with agency leaders."

"Mr. Azar’s declaration of a public-health emergency on Jan. 31 meant that any lab that wanted to develop a test had to first seek approval from the FDA. The FDA didn’t clear any labs to conduct testing until Feb. 29, nearly a month later. For weeks, HHS blocked efforts to allow other labs’ involvement because Mr. Azar wanted the CDC to make and distribute the nation’s diagnostic tests.

Mr. Azar told associates he favored the CDC making its own test, rather than importing ones distributed by the World Health Organization, because the WHO tests weren’t reliable, citing a study published in the Chinese Journal of Epidemiology. That study has since been retracted.

Developing a test proved more complicated than anticipated. Days after the CDC began shipping tests in the first week of February, labs began calling. The tests were giving invalid results.

Mr. Azar was incensed. An FDA official flew to CDC headquarters in Atlanta and visited the lab that had prepared the tests. The lab was a mess and it became clear the tests had likely been contaminated"

"Throughout February, Mr. Azar continued to assure the president and the rest of the task force that HHS had the situation under control"

"Dr. Redfield never gave Mr. Azar a timeline for when the testing problem would be fixed, because he didn’t know what was causing the problem"

"On Feb. 25, Nancy Messonnier, a CDC official, said the agency was preparing for a potential pandemic and that community spread of the virus was likely. The stock market plunged.

At a media briefing later that day, Mr. Azar sought to quell concerns, saying the virus was “contained.”"