Tag Archives: Coronavirus Task Force Coordinator Debbie Birx

Coronavirus, Donald J Trump

Trump, Repugnants and the Rich Do NOT Care About You: Relaxed restrictions across US will have a dire impact on coronavirus death toll, experts warn

Leave a comment

Relaxed restrictions across US will have a dire impact on coronavirus death toll, experts warn
By Christina Maxouris, CNN
https://www.msn.com/en-us/news/us/relaxed-restrictions-across-us-will-have-a-dire-impact-on-coronavirus-death-toll-experts-warn/ar-BB13BuQW?li=BBnb7Kz

Public spaces were filled with visitors over the weekend as some states began loosening lockdown measures and experts now warn the premature reopening could drive up the country’s coronavirus death toll — by nearly double, according to one prediction.

In the past two weeks, governors across the country introduced plans for phased reopenings amid mounting pressure from residents and businesses who are fearful of devastating economic impacts of lockdowns.

But the alternative could be worse.

“It’s the balance of something that’s a very difficult choice,” Dr. Anthony Fauci, the country’s leading infectious disease expert, told CNN Monday night. “How many deaths and how much suffering are you willing to accept to get back to what you want to be some form of normality, sooner rather than later?”

At least 42 states will be partially reopened through May 10, including California — the first state to implement a sweeping stay-at-home order — where some stores will be allowed to reopen this week.

A model from the Institute for Health Metrics and Evaluation at the University of Washington is now predicting the US could see 134,475 deaths by early August — a massive spike since its previous prediction of 74,000 deaths just last week.

A separate model from the Trump administration is also projecting that cases and deaths will rise in the next weeks, with the death toll reaching 3,000 daily victims by June 1, according to an internal document obtained by The New York Times.

So far, the US has recorded more than 1,180,600 infections and at least 68,934 deaths. Over the weekend, parks in New York City and Atlanta drew crowds as residents began venturing out of their homes. In the city of Miami Beach, more than 7,300 warnings were issued to people who weren’t wearing face covers, while more than 470 warnings were given to those who failed to practice social distancing.

Forgetting about social distancing measures too quickly can result in a rebound, Fauci says. And that’s highly likely with a virus that he says can spread “like wildfire.”

“It has a phenomenal capability and efficiency in spreading from person to person,” Fauci said Monday. “This virus has enormous capabilities of spreading like wildfire. We know that.”

How governors are moving forward

California was one of the states where crowds gathered over the weekend — thousands of protesters descended on the state’s Capitol and an Orange County beach to protest social distancing orders from the governor.

On Monday, the governor announced retail shops in the state — including clothing stores, florists and book shops — can begin to reopen on Friday, after health officials said the state was meeting important metrics including sufficient test and tracing capacity.

Los Angeles Mayor Eric Garcetti said he didn’t think his city would reopen this week, saying Monday that despite the governor’s announcement, different parts of the state may see different timelines for reopening.

In Michigan, Gov. Gretchen Whitmer said the lockdown will continue “until at least May 15,” warning that reopening the state too soon could lead to a second shutdown.

Kentucky Gov. Andy Beshear, who has laid out a phased reopening approach for the state, said Monday the numbers in Kentucky are “really steady” even with an increase in testing.

When he was asked why the state had forgone the recommended benchmark of seeing a 14-day decline in cases before beginning to reopen he said, “I will tell you, I never thought we’d be plateaued for three weeks, that’s a great thing with more testing.”

And in Mississippi, Gov. Tate Reeves took a more aggressive approach, releasing new guidelines that go into effect this week.

Those include allowing outdoor gatherings of up to 20 people.

Saying he knows the virus doesn’t do well in the sun or heat, he added, “to be outdoors is about the safest place you can be.”

The governor’s plan also allows dining service in restaurants — as long as the institutions follow guidelines provided by the state, including a mandatory deep cleaning.

“I don’t want to wait if there are steps that we believe we can safely take now to ease the burden on Mississippians fighting this virus,” he said.

Protests against masks

As health officials and businesses navigate safe re-openings, many communities — and the federal government — have urged Americans to wear face coverings when they’re in public and in parts of the US it’s now required.

But those guidelines have also seen push-back — most recently in Michigan’s Capitol building, where hundreds of protesters showed up — most of whom, were not covering their face.

On Friday, a security guard was shot in the head and killed after telling a customer at a Michigan Family Dollar store to wear a face mask. The governor required face masks in enclosed public spaces in late April. Three people have been charged.

In Stillwater, Oklahoma, an emergency proclamation issued to require face masks in stores and restaurants was amended a day later after store employees were “threatened with physical violence and showered with verbal abuse,” Stillwater City Manager Norman McNickle said in a statement.

And in San Diego County, a supermarket customer wore a Ku Klux Klan-style hood to cover his face and only removed it at the cashier despite having been repeatedly asked to multiple times before, CNN affiliate KSWB reported.

Coronavirus, Democrats, Donald J Trump

Trump to New York: You’ve Been Mean to Me, Drop Dead

Leave a comment

Trump to New York: You’ve Been Mean to Me, Drop Dead
By Asawin Suebsaeng, Erin Banco and Sam Stein
https://www.thedailybeast.com/trump-to-new-york-youve-been-mean-to-me-drop-dead?via=rss&source=articles_fancylink

Democratic governors, including Andrew Cuomo, are grappling with a coronavirus-related fear: piss off the president and risk losing his support.

As the coronavirus pandemic has deepened, Democratic governors bearing the heaviest burdens are increasingly wary that if they complain too loudly about the federal response they will anger Donald Trump and risk losing critical support during a life-or-death crisis.

The latest evidence of the delicate, sometimes impossible line that these governors have been forced to walk came Tuesday, when the president took swipes at New York Gov. Andrew Cuomo during a televised town-hall-style program on Fox News.

“I watched Gov. Cuomo [today] and he was very nice,” the president said of the man steering the state hardest hit by the virus. Cuomo had, moments earlier, conducted a press conference in which he scoffed at how insufficient the administration’s help in procuring ventilators had been. 

“He had a choice… He refused to order 15,000 ventilators,” Trump said, referencing a recent column by Betsy McCaughey, a hardened Trump supporter and longtime health-care policy crusader on the right. “It says that he didn’t buy the ventilators in 2015 for a pandemic, established death panels and lotteries instead.” 

Trump would go on to insist he was not blaming Cuomo. But the magnanimity was short-lived. “It’s a two-way street,” Trump said of having the feds help states with a coronavirus response policy. “They have to treat us well, too.” 

Under normal circumstances, such a screed would be cast aside as a classic bit of Trumpian shit-talking and thin-skinness. But these aren’t normal times. And Trump’s comment resonated not only for how callous it seemed but also for how manufactured the evidence was that he was citing.

A source on Gov. Cuomo’s team told The Daily Beast they believed McCaughey was referencing a 2015 New York government health report on ventilator guidelines for her column. The report’s data on ventilator need was based on numbers gathered for the 1918 influenza pandemic. The report’s guidelines went on to say that it was “not possible to accurately calculate the impact of a severe pandemic, including ventilator need” and that it is “likely that the approach used overestimates the number of ventilators that would be needed during a severe pandemic.”

President Trump “obviously didn’t read the document he’s citing—this was a five-year-old advisory task-force report, which never recommended the state procure ventilators—it merely referenced that New York wouldn’t be equipped with enough ventilators for a 1918 flu pandemic,” said Dani Lever, director of communications for Cuomo. “No one is, including Mr. Trump.”

For Trump, it was just the latest in an on-again, off-again relationship that has developed between him and the governor of the state he used to call home. The relationship between the two has changed from week to week, if not day to day, vacillating from gracious words to open hostility, depending on the news cycle. Such work-relationship dysfunction may seem abnormal, especially in the midst of a deadly, economy-tanking pandemic. But for those close to the president, it was standard operating procedure.

“If you’re good and respectful to [Trump], he will treat you the same—it’s that simple,” said one senior White House official. “The president has always said that he fights back when he needs to, and the situation with [Cuomo] is no different. If you keep that in mind, their sort of seesaw relationship during [coronavirus] doesn’t come as a surprise.”

Another person who had spoken to the president earlier this month recounted that one day Trump had mentioned in a meeting how well Cuomo was behaving and handling the crisis, only to, two days later, start bashing the governor in a different private conversation as “nasty.”

A source on the New York governor’s team said that Cuomo has tried to shrug off these temperamental swings over the last two weeks, saying Trump’s mood changes so often that it is hard to keep track. Another individual familiar with the relationship said it’s become expected that the pair will collaborate one day and the president will take a swipe at the governor for not doing enough the next, usually in the hours after the governor’s morning press conference.

Cuomo, the individual close to the governor noted, has praised the White House in addition to criticizing it on occasion. For example, when the administration facilitated the construction of hospitals and sent the Army Corps of Engineers to the state to help, Cuomo was gracious. And in press conferences, he has repeatedly thanked the president and noted that he and Trump speak often about what New York needs to battle the public-health epidemic. At other times, though, Cuomo has blasted the federal government, not necessarily Trump himself, for the delay and lack of much-needed essential medical supplies that health-care workers need to treat coronavirus patients.

That was true on Tuesday, when Cuomo said the state is in need of 30,000 ventilators and was getting insufficient help from the federal government to acquire more. The Trump administration said later that it was in the process of shipping about 4,000 ventilators to New York. But the governor’s office is still desperate for more and has called on the president to implement the Defense Production Act and order private companies to make more for the open market.

That Cuomo has made sharper demands than others is not lost on the White House. Nor is it lost as to why. His state has faced the brunt of the coronavirus crisis. And on Tuesday evening, Deborah Birx, a key member of Trump’s coronavirus task force, said at a White House press briefing that people who’ve left New York City recently should self-quarantine for 14 days. “To everyone who has left New York over the last few days, because of the rate of the number of cases, you may have been exposed before you left New York,” Birx said. “Everybody who was in New York should be self-quarantining for the next 14 days to ensure that the virus doesn’t spread to others.”

Trump, who was at the briefing, declined to say if he’d given Cuomo advance warning about the pronouncement. “We’re talking to them about it,” the president told reporters at the White House.

But while Trump’s attention seems to be focused on parrying with Cuomo, other Democratic governors have felt the pressure to not get on his bad side as well. One of those governors has been Jay Inslee of Washington, whose state preceded New York in having to deal with a massive wave of coronavirus infections and deaths. This month, the president called Inslee a “snake” and even instructed his vice president “not to be complimentary” of him. For weeks, the governor and president did not speak, though Tara Lee, a spokesperson for Inslee, told The Daily Beast that they connected over the weekend for the first time, during which Trump told Inslee that he was not getting a medical boat he had requested but would be “getting field hospitals.”

For Democrats working for governors on the frontlines of the crisis, the lesson taken from that episode and from Cuomo is that there are two administrations to navigate: the one doing the actual crisis response, and the one that is responsive to Trump’s id. 

“It is really unclear how many decisions are made by Trump versus the actual team there. Everyone is negotiating the challenge of telling the federal government where they are falling behind versus making sure we meet the needs of our citizens by getting federal help, knowing that you risk it if you anger Trump,” said an aide to a Democratic governor involved in handling the coronavirus spread. “It’s a balance that all governors are dealing with right now. Well, not all governors. Democratic governors.” 

As they deal with that balance, Democrats say they can already see potholes ahead. Trump has said in recent days that he wants to “re-open” the economy soon—perhaps by Easter—in hopes of avoiding an economic depression. But there is little the president can do to compel states to end their decrees that people stay in place or that all non-essential businesses close. Should they not bow to Trump’s demands, the fear goes, it will set up a situation in which he may once again use the bully pulpit to, well, bully. 

“He’s been trying to kick the blame to the states… and I think this maneuver [to re-open the economy] is the same,” said one Democratic operative who works on gubernatorial campaigns. “It’s him being able to say: ‘Hey, I opened it up, it’s not my decision that your state kept the economy closed. It’s not on me that you lost your job. Blame your governor.’” 

Coronavirus, Donald J Trump, Jared Kushner

Don’t Worry, America, Jared Kushner Is Going to Save You From COVID-19

Leave a comment

Don’t Worry, America, Jared Kushner Is Going to Save You From COVID-19
By Molly Jong-Fast
https://www.yahoo.com/news/don-t-worry-america-jared-080530606.html

Wednesday, during the latest installment of his daily briefings that have become must-see TV, New York Gov. Andrew Cuomo said he spoke with Jared Kushner. You know Kushner—the president’s son-in-law. The president’s son-in-law is a member of the president’s COVID-19 taskforce, but he is not a doctor or an elected official. In fact, Jared has no experience handling pandemics, or any medical background whatsoever. Jared Kushner doesn’t know about science or medicine but Cuomo must appeal to him for help from the federal government.

And that’s not the only place the president’s son-in-law has popped up the last few days.  One of the biggest questions we’ve all been puzzling over is, why won’t the president invoke the wartime Defense Production Act to force companies to make ventilators?

He “signed two executive orders citing provisions of the Defense Production Act” but then refused to use those provisions. Later it was revealed that Trump refused to use the wartime law “reportedly after corporations successfully lobbied his top adviser and son-in-law, Jared Kushner.” Meanwhile, Cuomo holds continual pressers that have the same refrain again and again: “We need the federal help, and we need the federal help now.”

As the pandemic fills New York City’s morgues, the president has decided to bring in the very best and smartest people. For Donald Trump, that’s his son-in-law, Jared Kushner. And it just makes sense, since Jared has already brought peace to the Middle East and innovated America within an inch of its life with his office of American innovation. Now it’s time for the young slumlord to once again fail upwards. This time, hundreds of thousands of American lives are at stake, but I mean, Jared did go to Harvard (via a $2.5 million donation), so…

First, Jared explained to his father-in-law that the media was making too much of the whole pandemic thing. “Mr. Kushner’s early involvement with dealing with the virus was in advising the president that the media’s coverage exaggerated the threat,” according to The New York Times. Sounds like Kushner agreed with Lou Dobbs—you know, Fox Business Channel’s Lou Dobbs, who’s in quarantine right now because he was exposed to liberal hoax COVID-19.

But wait, there’s more. It turns out that Jared is as good at handling a pandemic as he is at Middle East peace. First, he asked his brother’s wife’s dad for advice on handling the outbreak. Dr Kurt Kloss (father of model Karlie) wrote on Facebook, “If you were in charge of Federal response to the Pandemic what would your recommendation be. Please only serious responses. I have direct channel to person now in charge at White House and have been asked for recommendations.” I mean it makes sense, since he’s a doctor and Facebook is a highly regarded and peer-reviewed medical journal.

Then Jared got going on what he does best, innovation. You’ll recall that error-filled Oval Office address, followed by the error-filled Rose Garden address, and the promise, as the Times reported, that “Google had developed a coronavirus testing website that did not exist. Mr. Kushner was deeply involved in both efforts, and had sold his father-in-law on the website as a smart concept.”

This fiasco ended with Dr Deborah Birx holding a large poster board of a Google testing site that doesn’t exist. But that was a week ago. Since that innovation, we learn that Trump has pivoted to an Easter society-restart date. and Jared may have had his hand in that too. As Vanity Fair reported, “Jared is bringing conspiracy theories to Trump about potential treatments,” leading Trump to think he can ignore the person who actually knows about pandemics and public health, Dr. Anthony Fauci.

But Jared’s not the only one in the Trump family hoping to use the pandemic to grow their brand. Ivanka is trying her hand at being a coronavirus lifestyle influencer. When she came into contact with the Australian minister Peter Dutton and was sent home to isolate, Ivanka then suggested a faux -out with her children: “Staying home today w/ kids? Plan living room camp out!” she suggested on Tuesday, alongside a photo, taken a few years ago, of her hanging out with the children in a tent made out of sheets. Plan a menu & ‘pack’ sandwiches, salads (S’mores optional)! A fun activity that also brings family together for a meal!”  

The irony is that Ivanka’s dad is famous for putting immigrant children in tent cities in the hopes of owning the libs. But Ivanka’s COVID-influencer lifestyle seems to have ended. She tested negative (there seem to be unlimited COVID-19 tests for the royal family) and is back at work in the White House doing whatever it is she does.

One might find the fact that one in 1,000 people in the New York City metro area are infected with COVID-19 terrifying. But not me. No, I have confidence that the president’s son-in-law will handle this with his usual competence. I mean, we have peace in the Middle East now so… Wait, we don’t? Oh well then. I would say we’re all in a lot of trouble. But if we survive, just think about how good this will be for the Trump brand and for Ivanka’s 2024 run. If we don’t die, that is.

Coronavirus, Democrats, Donald J Trump, GOP, Republicans

Trump’s mismanagement helped fuel coronavirus crisis

Leave a comment

Trump’s mismanagement helped fuel coronavirus crisis
Current and former administration officials blame the president for creating a no-bad-news atmosphere that stifled attempts to combat the outbreak.

By Dan Diamond
https://www.politico.com/news/2020/03/07/trump-coronavirus-management-style-123465

On Friday, as coronavirus infections rapidly multiplied aboard a cruise ship marooned off the coast of California, health department officials and Vice President Mike Pence came up with a plan to evacuate thousands of passengers, avoiding the fate of a similar cruise ship, the Diamond Princess, which became a petri dish of coronavirus infections. Quickly removing passengers was the safest outcome, health officials and Pence reasoned.

But President Donald Trump had a different idea: Leave the infected passengers on board — which would help keep the number of U.S. coronavirus cases as low as possible.

“Do I want to bring all those people off? People would like me to do it,” Trump admitted at a press conference at the CDC later on Friday. “I would rather have them stay on, personally.”

“I don’t need to have the numbers double because of one ship that wasn’t our fault,” Trump added, saying that he ultimately empowered Pence to decide whether to evacuate the passengers.

For six weeks behind the scenes, and now increasingly in public, Trump has undermined his administration’s own efforts to fight the coronavirus outbreak — resisting attempts to plan for worst-case scenarios, overturning a public-health plan upon request from political allies and repeating only the warnings that he chose to hear. Members of Congress have grilled top officials like Health and Human Services Secretary Alex Azar and Centers for Disease Control Director Robert Redfield over the government’s biggest mistake: failing to secure enough testing to head off a coronavirus outbreak in the United States. But many current and former Trump administration officials say the true management failure was Trump’s.

“It always ladders to the top,” said one person helping advise the administration’s response, who noted that Trump’s aides discouraged Azar from briefing the president about the coronavirus threat back in January. “Trump’s created an atmosphere where the judgment of his staff is that he shouldn’t need to know these things.”

Interviews with 13 current and former officials, as well as individuals close to the White House, painted a picture of a president who rewards those underlings who tell him what he wants to hear while shunning those who deliver bad news. For instance, aides heaped praise on Trump for his efforts to lock down travel from China — appealing to the president’s comfort zone of border security — but failed to convey the importance of doing simultaneous community testing, which could have uncovered a potential U.S. outbreak. Government officials and independent scientists now fear that the coronavirus has been silently spreading in the United States for weeks, as unexplained cases have popped up in more than 25 states.

“It’s a clearly difficult situation when the top wants to hear certain answers,” said one former official who’s briefed the White House. “That can make it difficult for folks to express their true assessment — even the most experienced and independent minds.”

While Trump last week allowed hospitals and labs to start developing their own coronavirus tests, wrongly blaming Obama administration regulations for a delay, the same move could have been made weeks ago had the president and his advisers felt it was necessary, said two officials.

The White House press office declined to comment on the record, referring questions to HHS.

The health department said that Trump had been responsive to the department’s concerns and understood the seriousness of the coronavirus threat from the first day he was briefed.

“The President took early and decisive actions like instituting travel restrictions and utilizing the quarantine authority” to protect Americans from the outbreak, an HHS spokesperson said.

HHS also stressed that Azar and Trump had a good working relationship.

“The Secretary always offers the President his honest assessment, and always insists when briefing the President on public health issues that the relevant experts participate,” the spokesperson said.

Trump-inspired disorganization plagues early response

As the outbreak has grown, Trump has become attached to the daily count of coronavirus cases and how the United States compares to other nations, reiterating that he wants the U.S. numbers kept as low as possible. Health officials have found explicit ways to oblige him by highlighting the most optimistic outcomes in briefings, and their agencies have tamped down on promised transparency. The CDC has stopped detailing how many people in the country have been tested for the virus, and its online dashboard is running well behind the number of U.S. cases tracked by Johns Hopkins and even lags the European Union’s own estimate of U.S. cases.

After senior CDC official Nancy Messonnier correctly warned on Feb. 25 that a U.S. coronavirus outbreak was inevitable, a statement that spooked the stock market and broke from the president’s own message that the situation was under control, Trump himself grew angry and administration officials discussed muzzling Messonnier for the duration of the coronavirus crisis, said two individuals close to the administration. However, Azar defended her role, and Messonnier ultimately was allowed to continue making public appearances, although her tone grew less dire in subsequent briefings.

Trump’s defenders can point to many coronavirus crises that, so far, have been failures of bureaucracy and disorganization. The president didn’t lock out a government scientist from CDC. He didn’t know that officials decided to fly back coronavirus-infected Americans aboard planes with hundreds of others who had tested negative, with Trump bursting in anger when he learned the news.

But Trump has added to that disorganization through his own decisions. Rather than empower a sole leader to fight the outbreak, as President Barack Obama did with Ebola in 2014, he set up a system where at least three different people — Azar, Vice President Mike Pence and coronavirus task force coordinator Debbie Birx — can claim responsibility. Three people who have dealt with the task force said it’s not clear what Birx’s role is, and that coronavirus-related questions sent to her have been rerouted to the vice president’s office.

In response, Pence’s office said it has positioned Birx as the vice president’s “right arm,” advising him on the response, while Azar continues to oversee the health department’s numerous coronavirus operations.

Trump on Friday night also shook up White House operations, replacing acting Chief of Staff Mick Mulvaney with Rep. Mark Meadows, a longtime ally. The long-expected ouster of Mulvaney was welcomed in corners like the health department, given that Mulvaney had been one of Azar’s top critics. But the abrupt staff shuffle in the middle of the coronavirus outbreak injects further uncertainty into the government’s response, said a current official and two former officials. It’s not yet clear what Mulvaney’s departure will mean for his key lieutenants involved in fighting the outbreak, like Domestic Policy Council chief Joe Grogan, for instance.

“Every office has office politics — even the Oval Office,” said one individual. “You’d hope we could wait to work it out until after a public health emergency.”

Health officials compete for Trump’s approval

The pressure to earn Trump’s approval can be a distraction at best and an obsession at worst: Azar, having just survived a bruising clash with a deputy and sensing that his job was on the line, spent part of January making appearances on conservative TV outlets and taking other steps to shore up his anti-abortion bona fides and win approval from the president, even as the global coronavirus outbreak grew stronger.

“We have in President Trump the greatest protector of religious liberty who has ever sat in the Oval Office,” Azar said on Fox News on Jan. 16, hours after working to rally global health leaders to fight the United Nations’ stance on abortion rights. Trump also had lashed out at Azar over bad health-care polling that day.

Around the same time, Azar had concluded that the new coronavirus posed a public health risk and tried to share an urgent message with the president: The potential outbreak could leave tens of thousands of Americans sickened and many dead.

But Trump’s aides mocked and belittled Azar as alarmist, as he warned the president of a major threat to public health and his own economic agenda, said three people briefed on the conversations. Some officials argued that the virus would be no worse than the flu.

Azar, meanwhile, had his own worries: A clash with Medicare chief Seema Verma had weakened his standing in the White House, which in December had considered replacements for both Azar and Verma.

“Because he feels pretty insecure, about the feuds within his department and the desire to please the president, I don’t know if he was in the position to deliver the message that the president didn’t want to hear,” said one former official who’s worked with Azar.

The jockeying for Trump’s favor was part of the cause of Azar’s destructive feud with Verma, as the two tried to box each other out of events touting Trump initiatives. Now, officials including Azar, Verma and other senior leaders are forced to spend time shoring up their positions with the president and his deputies at a moment when they should be focused on a shared goal: stopping a potential pandemic.

“The boss has made it clear, he likes to see his people fight, and he wants the news to be good,” said one adviser to a senior health official involved in the coronavirus response. “This is the world he’s made.”

President swayed by flattery, personal appeals

Trump’s unpredictable demands and attention to public statements — and his own susceptibility to flattery — have created an administration where top officials feel constantly at siege, worried that the next presidential tweet will decide their professional future, and panicked that they need to regularly impress him.

The most obvious practitioner of this strategy is Azar, who became Trump’s second health secretary after the first, Tom Price, failed to bond with Trump and was ousted over a charter-jet scandal. Azar decided early in his tenure to have “zero daylight” with the president, said three individuals close to him, and the health secretary routinely fawns over the president in his TV appearances on Fox News. “No other president has had the guts, the courage to take on these special interests,” Azar told Fox News host Tucker Carlson in December after Trump pushed new price transparency on the health care industry.

Azar’s team also has insisted upon using background photos for his Twitter account that always show him with the president — sometimes silently standing behind Trump while he speaks. Azar is alone among Cabinet members in this practice; secretaries like HUD’s Ben Carson, Transportation’s Elaine Chao and Treasury’s Steven Mnuchin opted for bland Twitter backgrounds that show their headquarters.

“The Secretary respects the President and values their strong relationship,” said an HHS spokesperson, when asked about Azar’s approach to working with Trump and use of Twitter photos.

Other health officials have modeled similar behavior as Azar. Asked by Trump if he wanted to make a “little statement” on Friday, CDC Director Redfield responded by praising the president’s “decisive leadership” and visit to CDC headquarters amid the outbreak. “I think that’s the most important thing I want to say,” Redfield said.

At least one health official has offered a more subtle reminder of her loyalties. Verma wore an Ivanka Trump-brand pendant to some meetings and events with the president, before it was stolen in 2018.

Health officials also have to guard their words and predictions, worried that the president will fixate on the wrong data point or blurt out damaging information in public. Trump on Friday told reporters that he’d initially scrapped a trip to the CDC because of a possible coronavirus case at the agency. The announcement came as a surprise to CDC staff, including those preparing for Trump’s visit, because they hadn’t been briefed on the potential coronavirus case, POLITICO first reported.

I just got off the phone with the President. He told me that his administration will not be sending any victims of the Coronavirus from the Diamond Princess cruise ship to Anniston, Alabama. Thank you, @POTUS, for working with us to ensure the safety of all Alabamians.— Richard Shelby (@SenShelby) February 23, 2020

Meanwhile, Trump’s political allies have tried to circumvent the policy process, causing further headaches for the overwhelmed health department. Alabama Republicans prevailed upon Trump to scrap an HHS contingency plan to potentially quarantine some coronavirus-infected Americans at a facility in their state last month.

“I just got off the phone with the President,” Sen. Richard Shelby tweeted on Feb. 23. “He told me that his administration will not be sending any victims of the Coronavirus from the Diamond Princess cruise ship to Anniston, Alabama.”

But Democrats in a California city facing a similar situation failed to get a similar guarantee, leading them to file a lawsuit that accused the administration of political favoritism.

“California must not have the pull to get taken off the list,” attorney Jennifer Keller, representing Costa Mesa, Calif., reportedly said during a court hearing last month. “Alabama does.” A federal judge later halted plans to transfer coronavirus-stricken patients to a facility in the city.

Meanwhile, the president has allowed feuds to fester and spill into public view. Azar, for instance, has battled with White House officials and Verma for months over policies, personnel and even seats aboard the presidential airplane. Those fights have been reignited amid the coronavirus crisis, when Azar clashed with longtime rivals like Grogan over funding the response and whether enough coronavirus tests were being performed.

They’ve also cast a long shadow over strategy, like Azar’s decision not to push for Verma to be added to the coronavirus task force that he oversaw for nearly a month. Verma instead was added to the task force on March 2, several days after Pence took over leading the effort. While Azar said he asked for Verma to join the task force, and an HHS spokesperson pointed to the secretary’s public statement, two people with knowledge of task force operations said that the White House officials had raised questions about her omission.

Officials call the original decision to exclude Verma from the task force short-sighted at best, given the virus’ potential threat to the elderly patients covered by the Medicare program and residents living in nursing homes that are regulated by Verma’s agency.

With Trump unwilling — or unable — to put a stop to the health department’s fights, they’ve occupied and gripped Washington during relative peacetime. When at war against a potential pandemic, there’s no room for these distractions, officials say.

“If this sort of dysfunction exists as part of the everyday operations — then, yes, during a true crisis the problems are magnified and exacerbated,” said a former Trump HHS official. “And with extremely detrimental consequences.”