Dr. Deborah Birx, who served in the Trump administration as part of the Covid response team, has admitted in her book and before Congress that much of the guidance issued to mitigate the pandemic was arbitrary. In her book Silent Invasion, she discusses the planning that went into an essential component of the strategy to handle Covid, one that has been roundly mocked: two weeks to stop the spread. The data used to back it up was from other countries, and Birx intentionally obfuscated her intentions for a robust lockdown.
Birx writes in her book, she writes about assembling a team that she could "trust" to "look at the numbers and provide unvarnished analysis free from a hidden or political agenda. There would be no groupthink within my inner circle." But after deciding to trust the data, Birx noted that the "CDC didn't have the demographic data [she] was looking for. Worse, the data it did have would never help paint an accurate picture of this pandemic outbreak."
The data, as it was gathered, the sources it was gathered from, and the methods, was not adequate to give a clear picture that could be used to make conclusive public health recommendations. Birx said that there was essentially a "silent" spread of Covid and there was no way to track it. This, she said, led to the US staying "stalled in the 'containment' phase rather than aggressively mitigating. The normal way to track a virus was through detecting symptoms, but without seeing symptoms, there was no way to track it. What Birx was looking for was a "Plan B."
"The existing CDC data" wasn't of any use, Birx said, picking apart the CDC's approach, saying that they should have been more forceful in their data collection and in going to states and demanding information.
Despite not having adequate data, Birx pushed ahead with her plans to convince Trump and his advisors to go along with her mitigation plans. She writes that in March 2020, she met with the President, and her plan was to obfuscate her intentions for economic shutdowns, knowing that Trump was wary of anything that would tank the economy he had worked so hard to build.
"I couldn't do anything that would reveal my true intention," she writes, "to use the travel ban as one brick in the construction of a larger wall of protective measures we needed to enact very soon." Trump's team was more concerned about the impacts and potential for loss of lives to Americans of shutting society down. She blasts the administration for their concerns over the economy, concerns which have played out in real time to the point where the country could be facing devastating impacts, as is the globe.
She writes that "the failure here does not belong to any one institution or person. It's bigger than that, broader than that. It defies easy explanation or reflexive answers. It's easy to lay the blame at the feet of the Trump administration… but it's crucial to understand that the CDC had been fully funded for global health security since 2009." In Birx's view, while Trump does take much of the blame, this was a failure of the CDC and the Department of Health and Human Services.
It was because of these failures that when it was time to offer guidance it was based on speculation and was arbitrary. The two week quarantine was eventually lessened to 10 days, and then to five.
Birx urges solutions to the problem of data collection, saying that "there remains a lack of emphasis on active testing, and there is still no sense of urgency to find the silent community invasion that occurs days to weeks before symptoms." Birx and her cohort relied on data from other countries "where the data was available." And it wasn't just with data on spread, but "the same was true for vaccines and the durability of vaccine protection" we had to rely on the well-collected data from other countries to make decisions in this country." Birx laments that this was so.
Birx presented data culled from European and Asian nations, notably Italy, South Korea and China. "Interpreting data," she wrote, "would become the new battlefield." She pushed a travel ban through, she writes, and then used it, as was her aim, to create a proposal to "flatten the curve."
"Getting the travel ban through was a crucial first test of my data-driven approach," she writes. "That it worked would, I hoped, make the end-of-the-week pitch for our version of flattening-the-curve-to-protect hospitals 'shutdown' easier." Birx and her team shifted into high gear to get that plan past the goalie, using not US data but an amalgamation of data from other nations, which did not include economic data, forecasts, or predictions.
In light of this failure of data from all angles, Birx and her team used terms that they believed would be palatable to the economic team, noting that "we decided to take these [economic-based concerns] directly, highlighting 'preemptive' and 'low-cost' interventions." These included hand sanitizer, but not masks, which Birx would later come to regret. As recently as June 2022, Birx wore a face mask when testifying before the US House.
Birx laments, looking back, that they were not more stern in their approach to guidance, saying that it is concerning that people would not "prioritize the health of others over their own personal liberty." Birx notes that "early data from Europe showed widespread compliance."
In one section, Birx writes about how her team would give draft guidance to the Trump administration only for advisors there to alter or rearrange it, at which time her team would put it back in and deliver it to governors and other agencies.
Birx set about trying to get everyone on the team to agree to "shutdown-life measure." Dr. Anthony Fauci wasn't initially on board because he questioned the data, or lack thereof. It was during a meeting off-site, at Birx home on March 14, 2020, that Birx broached the idea of a 15-day shutdown. And after reviewing data from Europe, the team agreed.
"One of the key decisions made at the meeting was on the fifteen-day time frame during which we'd ask all Americans to do their part. Instead of just asking people to be vigilant during the flu season and to cough and sneeze into their elbows instead of their hands, we'd ask for other behavioral changes more in line with the silent spread mitigation," she writes.
"To arrive at 'fifteen days' we had relied on the CDC's estimate of this virus's full transmission cycle (from inhalation of droplets or airborne particles to viral shedding infectivity), a maximum of fourteen days. This was the justification for the exposure and quarantine times being used around the globe," Birx writes.
But for her, 15 days was not a maximum, but merely "a starting point."
"Ultimately," she writes, "cross-household gatherings needed to be stopped entirely, households isolated from other households to prevent further spread. Limiting gatherings to ten has been a first step and was consistent with my spoonful-of-sugar approach." In short, Birx had plans for a major lockdown, but only gave guidance in small bites in order to soften up the Trump administration, and the American public, to the deletion of their rights to gather freely, to go to work or church unimpeded, and to live their lives.
"No sooner we had we convinced the Trump administration to implement our version of a two-week shutdown than I was trying to figure out how to extend it," she writes, despite not having the data to back up her intention. "Fifteen Days to Slow the Spread was a start," she writes, "but I knew it would be just that. I didn't have the numbers in front of me yet to make the case for extending it longer, butI had two weeks to get them."
Birx's plans likely would not have been successful had she laid them bare at the outset, but Americans would not have felt quite so betrayed, so put through the ringer, as they did when the guidance kept changing, kept becoming more restrictive. At each step of the pandemic mitigation, Americans gave up their rights, and then, only days or weeks later, they were asked to give up more.
In reaction to this reality, Rep. Jim Jordan of Ohio questioned Birx before the US House in June, asking "why should Americans believe anything the government says about COVID?" He quoted President Biden, who made a number of claims that later proved to be false, such as his statement that those who are vaccinated cannot catch Covid. Jordan referenced Birx's testimony on the lack of data that was used to implement economic and social shutdowns.
Jordan further asked Birx "when the government told us, told the American people, that people who had been vaccinated couldn't get it, were they guessing or were they lying?"
"I don't know," Birx said. "All I know is there was evidence from the global pandemic that natural reinfection was occurring. And since the vaccine was based on natural immunity, you cannot make the conclusion that the vaccine will do better than natural infection, although it can often do slightly better."
"When the government told us that the vaccinated couldn't transmit it, was that a lie or was that a guess? Or is it the same answer?" Jordan asked.
"I think it was hope that the vaccine would work in that way," Birx said, going on to say that doctors and public health experts need to be "at the table."
"You said you think it was hope?" Jordan asked. So what we do know is it wasn't the truth. So they were either guessing, lying or hoping, and communicating that information to the citizens of this country."
"I think they were hoping," Birx said, noting again the problems of data and data collection.
"I'm just struck with the irony. We've got government agencies guessing, hoping or lying with information they're presenting to the American people," Jordan said, noting that the Biden administration had looked to create a Disinformation Governance Board when they are "the biggest purveyors of misinformation, false information, hopeful information, but not accurate and true information."
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