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CNN Special Reports
CNN Special Report, COVID WAR: The Pandemic Doctors Speak Out. Aired 9-10p ET
Aired March 28, 2021 - 21:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
[21:00:00]
PAMELA BROWN, CNN SENIOR WHITE HOUSE CORRESPONDENT: I'm Pamela Brown. Good night.
UNIDENTIFIED MALE: The following is a CNN Special Report.
UNIDENTIFIED MALE: The coronavirus pandemic is raging out of control in the U.S.
UNIDENTIFIED FEMALE: The (ph) health care system at a tipping point now.
UNIDENTIFIED MALE: Reporting (ph) close to 100,000 people in the United States --
UNIDENTIFIED MALE: Almost 300,000 coronavirus deaths.
UNIDENTIFIED MALE: The humanitarian disaster.
UNIDENTIFIED FEMALE: With milestone of 500,000 people dead from coronavirus.
DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: By almost every metric, COVID-19 overwhelmed the most powerful nation on the planet. And left all of us searching for answers.
UNIDENTIFIED FEMALE: How can I protect my children? How do we get food? Do we go to the supermarket?
GUPTA: As a doctor, journalist, and the father of three, I've been combing for those answers along with you.
Are the hospitals ready?
Examining the science.
There is evidence of asymptomatic spread.
And pressing our leaders.
This is spreading, it's going to spread within communities.
DONALD TRUMP, FORMER PRESIDENT OF THE UNITED STATES: Is that right? Because we're ready for it.
GUPTA: Now for the first time,
DR. DEBORAH BIRX, FMR. WHITE HOUSE CORONAVIRUS RESPONSE COORDINATOR: What was I thinking --
GUPTA: Free from the watchful eyes of the Trump White House.
DR. STEPHEN HAHN, FMR. FDA COMMISSIONER: I'm substantially conservative. GUPTA: The top doctors behind the COVID response are ready to talk about what went right.
DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE FOR ALLERGY AND INFECTIOUS DISEASES: The decision to develop a vaccine may have been the best decision that I've ever made.
GUPTA: And what really went so very wrong.
BIRX: There were about 100,000 deaths that came from that original search. All of the rest of them could have been mitigated.
DR. ROBERT REDFIELD, FMR. CDC DIRECTOR: I finally had a moment in life where I said, you know, enough, enough, I'm not changing even though he want (ph).
ROBERT KADLEC, FMR. ASSISTANT SECRETARY FOR PREPAREDNESS AND RESPONSE: They had about a 30 day head start.
REDFIELD: I could use the word cover up.
BIRX: I knew I was being watched.
GUPTA: Where you threatened?
FAUCI: This metaphorical autopsy with the doctors in charge won't bring back the hundreds of 1000s of Americans we've lost.
GUPTA: Hydroxychloroquine, was it the right decision? Do you regret it?
And it will not be a cure.
We were not testing enough.
REDFIELD: I agree with you.
GUPTA: We're still not testing enough.
REDFIELD: I agree with you.
GUPTA: But it might help us to better understand how we got here.
DR. BRETT GIROIR, AMERICAN PEDIATRICIAN: All of this was starting from scratch.
GUPTA: And hopefully how to move forward.
FAUCI: This is a war. So, if you're going to fight a war, you better start shooting at the enemy instead of each other.
KADLEC: As bad as this was, it could be worse, and there will be another pandemic guaranteed.
GUPTA: Doctors are not often thought to be introspective or reflective. Truth is though, most of the doctors I know are just that. Tormented by the past, the patients they couldn't help and those who they've lost.
In medicine, it is the autopsy that forces us to face our mistakes. An autopsy is far from easy. It is tough to bear witness. And we know it does nothing for the patient on the table. But we do it for the future, to ensure that our mistakes are not repeated. And the lessons that we learn. Help us to avoid every future preventable death we possibly can.
BIRX: I will figure it out. And I will make sure I don't make the same mistake twice.
FAUCI: Hi, Sanjay.
GUPTA: It is in that same spirit that I sat down with the top doctors in charge of the nation's pandemic response.
REDFIELD: It was so unbelievable.
GUPTA: Hi, Dr. Hahn. How are you doing?
For a year, they have carried the weight of the world on their shoulders.
Thank you for your time.
Only to see their tireless efforts and in what can only be described as tragedy.
More than 500,000 Americans gone.
We take off our masks.
All of the doctors agreed to meet in hopes of trying to figure out why.
If I told you that half a million people would have died by this a year later, would you believe me?
FAUCI: No, I would have been horrified that that was even a possibility that that would happen.
FAUCI: This is my haven and Christy's haven.
GUPTA: In an unusually frigid Saturday in Washington, I joined America's doctor for a long walk. CHRISTINE GRADY, ANTHONY FAUCI'S WIFE: We used to run, now we walk.
GUPTA: Alongside his wife and accomplished scientist Christine Grady.
[21:05:02]
This morning ritual has served as their refuge for nearly four decades, but particularly this past year through the ups and downs of Dr. Fauci's crusade against COVID-19.
GUPTA: Nothing in your life, like, could have prepared you for this?
FAUCI: No. It's like you're drinking out of a fire hydrant and all of these things are happening.
There was a time, probably it was in April or May when New York was on fire in the sense that I was working literally 19 hours a day because I felt I had to. And I was so exhausted, but didn't even realize how exhausted, it was Chris who said one night, timeout, do you see what you're doing? You know, you're not eating, you're not drinking any water, you're not sleeping. So, that was good that she did that.
GRADY: He work from 19 hours a day to 16 hours a day. He hasn't really changed much.
GUPTA: At 80 years old --
UNIDENTIFIED MALE: Please welcome to the show Dr. Anthony Fauci.
GUPTA: -- the nation's leading infectious disease expert has earned yet another title of sorts.
UNIDENTIFIED MALE: I'm Dr. Anthony Fauci.
GUPTA: Celebrity.
FAUCI: Thank you very much Mr. President.
GUPTA: After his steady presence prove one of the few constants in our lives over this chaotic year.
FAUCI: Every once in a while you stop and you think about and you say, my world has completely changed.
GUPTA: Yes.
FAUCI: But as it's changing you don't realize it's changing because you're just focusing, you know, we got to get a vaccine, we got to get a drug, we got to do this, we got to do that, and then every once in a while you say, well, wait a minute. I got two armed security guys here, I got another guy over there, and I'm on a path working with my wife, what is that all about?
GUPTA: Yes.
One year ago this March, the death threats began. Dr. Fauci has had secret service protection every step since.
BIRX: All the doctors received death threat.
GUPTA: Do you receive death threats?
BIRX: From the very beginning. My daughter has got the same route text messages. I mean you can't even imagine what those text messages look like.
A lot of sexual references saying the country would be better off if you were dead. You're misleading the country. Your tongue should be cut out.
Early on I took them to the State Department, you know, they said you just have to keep sending them to us. I didn't have time to do that.
GUPTA: Just a few days after she learned that unlike her longtime mentor Dr. Fauci, Dr. Deborah Birx would not be asked to continue her work into the Biden administration. I spoke with a 64 year old renowned immunologist about her time in the White House.
BIRX: I'm very self-reflective on what could I have done better, because I don't ever want us to make the same mistakes.
GUPTA: Is your sentiment right now, are you upset, are you frustrated, sad?
BIRX: I'm encouraged I'm encouraged that there's a team in the White House. It was very difficult being just one person in the White House. And I think people really didn't understand I was the coordinator of the response, I wasn't the originator of all of the responses.
HIV was what we call --
GUPTA: In March when Dr. Birx was recalled from her post as Global Aids Ambassador to join the task force, she had little experience working inside a White House and quickly realized that the role of the doctors was not going to be at all what she expected.
BIRX: Thank you, Mr. Vice President. Good evening.
I underestimated the White House and the politics. But throughout these 11 months, Dr. Fauci and I probably talked or text five out of seven days every week.
UNIDENTIFIED MALE: Our guests on Newsmakers Sunday today are Dr. Anthony Fauci.
GUPTA: This is not the first war Fauci and Birx have fought together. Before COVID-19, the two battled a another deadly virus, The HIV AIDS epidemic. It was an experience that greatly informed each of their approaches to this new fight.
As you were working together, did you have a strategy to do this, like good cop, bad cop? FAUCI: I was the bad cop. She was the good cop. They refer to me, as I often say, as the skunk at the picnic. Because whenever they would say things were great I would say, I don't really think so.
JIM ACOSTA, CNN CHIEF DOMESTIC CORRESPONDENT: Should Americans be prepared for the likelihood that there will be 100,000 Americans who die from this virus?
FAUCI: The answer is yes. We need --
It was easy for me to say that out loud and just openly say that, because I had my base. My base was the NIH. But Deb had a much more difficult situation. She had an office right there in the West Wing. So, I'm very, very reluctant to condemn anything that even though there are people who feel that she should have pushed more, she probably should have, but boy she did a lot of good. She knocked herself out getting up at 3:00 in the morning putting that data together, presenting it every day.
[21:10:02]
GUPTA: And you had your own group.
FAUCI: Right.
GUPTA: I love that there's the doctors group that was sort of this ancillary or separate secret group. But that was important for you.
FAUCI: Yes, no, it was important. We weren't secret about it. We were pretty open about it, just that not very many people knew about it.
By that time, the task force was irregularly meeting. But that was particularly when the campaign started, and that's when we started with the doctors group.
BIRX: We had a very strong coalition between Dr. Redfield, Dr. Hahn, myself, and Dr. Fauci. I thought it was very important because they were doing House and Senate briefings. I wanted them armed with everything that I could give them.
TRUMP: I see the disinfectant that knocks it out in a minute.
GUPTA: If you knew anything about this White House, they kind of had an anti-science, or at least not a significant science supported reputation. How did you plan on dealing with that?
BIRX: You know, I've dealt with presidents and prime ministers around the globe, who will often have misperceptions about diseases, and the community that that disease impacts. But I've always found that if you can find that common ground with the information and data, they will change policies.
He's been so attentive to the scientific literature and the details and the data. And I think --
And it's part of the reason why I did say at one time, the president looked at the data and understood the data, because he wouldn't have shut down the country for 15 days, and then another 30. But that never really happens again, because there were too many parallel streams of data.
UNIDENTIFIED MALE: Americans hear one thing from the CDC director and another thing from you, who are we to believe?
SCOTT ATLAS, FORMER WHITE HOUSE CORONAVIRUS TASK FORCE ADVISOR: You're supposed to believe the science and I'm telling you the science.
GUPTA: These parallel data streams, do you think they originated with Scott Atlas?
BIRX: I know some of them came from his team. I don't know where all of them came from.
GUPTA: What was the motivation, do you think to present data that was inaccurate or at least incomplete?
BIRX: I think they felt that they were defending their position. And they believe that everything that I did short of that was compromising the American economy, the American lifestyle. In their mind, all of those things outweighed the fatalities, and the hospitalizations that I was concerned about. But they also never took into account that there could be long term side effects from an even a mild case.
GUPTA: Do you think that's a real possibility?
BIRX: I don't know.
GUPTA: You see, with COVID-19, it's not just about who lives or dies. But also about those stuck in between, the long haulers, the unknowns of a new disease we've never seen before.
BIRX: I don't feel like you should say, oh, you're asymptomatic, or you're very mild, and you're going to be fine. I mean, I tracked all of them in the White House, because believe me, we had plenty of young people who got infected in the White House. And I tried to follow up with many of them. And some of them took weeks to redevelop their sense of taste and smell.
That's unusual. When you see things like that, that linger, you worry about what else is happening that you don't see.
FAUCI: It is an extraordinary virus. When you're in infectious diseases for your entire professional life, you kind of live in a metaphor. And the metaphor is that viruses particularly have a mind. They're smart, they're evil, or they're benign.
But a virus that has adapted itself, almost insidiously adapted itself perfectly to a human, not only my going to infect you, but I'm going to make sure that many of you don't have symptoms, and I'm going to use them to spread as much as I possibly can. And if I kill the vulnerables, I'm not going to eliminate the population. So, always have a lot of people that I can still infect. Now, that sounds crazy, but that's the metaphor that when you deal with infectious diseases, you say, damn this virus, it's such a bad, evil virus.
GUPTA: Was there a moment, Dr. Fauci, when you said OK, this is the big one.
FAUCI: Yes.
UNIDENTIFIED MALE: Forty percent increase in New York hospitals in just 24 hours. That's a big one.
FAUCI: When I saw what happen In New York City --
UNIDENTIFIED FEMALE: Refrigerated trucks are now being mobilized as makeshift forks.
FAUCI: -- almost over running of our health care system, it was like Oh my goodness. And that's when it became very clear that the decision we made on January the 10th to go all out and develop a vaccine may have been the best decision that I've ever made with regard to an intervention as the director of the institute.
[21:15:22]
GUPTA: The life saving and record-breaking vaccines that Dr. Fauci oversaw were a giant success for the doctors, for science, and for the world. But remember, a vaccine does nothing for the patient on the table. In this case, the hundreds of 1000s who perished before science could save them.
When you look at your data now, and you think, OK, had we mitigated earlier, had we actually paused earlier and actually done it? How much of an impact do you think that would have made?
BIRX: I look at it this way, the first time, we have an excuse, there were about 100,000 deaths that came from that original search, all of the rest of them, in my mind, could have been mitigated or decreased substantially.
If we took the lessons we had learned from that moment, that's what bothers me every day. And that's why I have to be able to process this and understand this because, like you said, in the post mortem, we have to come out of this and learn how to do it better the next time.
GUPTA: Up next, the first critical lesson from this autopsy.
REDFIELD: You know, I could use the word cover up but I don't that.
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[21:20:09]
GUPTA: To understand any disease, but especially one that is novel, one that scientists had never seen before, it is critical to go back to its origin and answer the most basic of questions, where was it first discovered, and how?
REDFIELD: An official word from the Chinese CDC was not transmissible, human to human. I had multiple discussions with my counterpart in China, George Gao, that I wanted to have our CDC office in Beijing, you know, deployed to help right there and I want to augment that by 20 or 30 people and get into Wuhan and try to answer a few questions. Is this human-human transmissible, yes or no? Is this transmissible only in symptomatic or is it asymptomatic are transmissible?
And I told him, I was concerned of human-human transmissible. And I said to George, you know, George, you don't really believe that mother and father and daughter all got the event from an animal at the same time, do you? So he said, Bob, there's just no evidence of human-human transmission.
GUPTA: But that was the evidence of human-human transmission.
REDFIELD: It was.
I would say, it was probably by the fifth of January, fourth or fifth of January, you know, I'd really told him he had to go out in the community and look for people that have unspecified pulmonary illness that didn't go to the C margin. And he did that. And that evening, he told me, they obviously found a lot of cases. And that evening, he was quite distraught, because he came to the conclusion that the cat was out of the bag, you know.
GUPTA: When he called you and was so upset, crying, distraught on the phone, that was a warning, wasn't it? He was now officially worried.
REDFIELD: Because you remember the early mortality in China, it was somewhere between 5 percent and 10 percent. I probably be crying too.
UNIDENTIFIED MALE: Wuhan is the city that is massive, 11 million people. It is essentially shut down. It is locked down. They are not letting anyone out via airport, via train station.
GUPTA: How much did you, did you trust the information coming out of China initially?
FAUCI: I always had skepticism about it because of what we went through with SARS. You know, people forget, but in SARS the Chinese is saying, oh, it's flu, it's flu in. And then the next thing you know that SARS was all over the world, in Canada and Australia, all over the place. So, they are not very transparent in the past. It wasn't out right lying, they just didn't give you all the information.
GUPTA: How big a difference would it have been if our own investigators had been on the ground in China?
FAUCI: I think it would have been a significant difference.
REDFIELD: I think we could have learned very quickly that we're dealing with a different beast than the one that everyone had sold us. They sold us this is like SARS. This is like flu. While SARS and flu, you can go after symptomatic case finding because they cause symptomatic disease. Unfortunately, this virus, probably a majority of its transmission is in the non-symptomatic stage.
The Chinese have reported that evidence of transmission and the asymptomatic phase based on data that they have reviewed, CDC has not been given the opportunity to review that data.
GUPTA: Suspicion of the data coming out of China had grown so deep that after Chinese scientists released a study on January 24, confirming the worst case scenario had arrived. Their first confirmed asymptomatic infection. Redfield, Fauci and others in the United States still needed to see the data in order to believe it.
FAUCI: As Bob said, and I agree we would really like to see the data.
GUPTA: Did you believe it to be true at that time? I mean, you're hearing this from China. But on January 28, you said in the history of respiratory --
FAUCI: All the history of respiratory borne viruses of any type, asymptomatic transmission has never been the driver of outbreaks.
Why exactly, I said that it is true. I mean, I find it interesting. People throw quotes back at you, you know, 910 months ago, and they say, ah, but you said in the history of respiratory diseases, that is an absolutely correct statement. But this was different. And that's the point and we were struggling what is how different is this?
GUPTA: Turns out this novel virus really was different, at least compared to the more recent outbreaks of SARS and MERS, which saw no significant asymptomatic spread. With COVID-19, more than half of those infected contracted the virus from someone without any symptoms at all, making it that much harder to diagnose and contain. The question is, why did it take until late March though, for the United States to finally figure that out.
[21:25:12]
FAUCI: I think if we had sent our people into Wuhan and able to talk to the Chinese scientists in a conversation that might have lasted an hour, you could have gotten so much information. Right from the get go, they would have told us don't believe what you're reading, this is spread asymptomatically, it spreads highly efficiently and it's killing people.
GUPTA: Do you know why now in retrospect you didn't get in?
REDFIELD: Well, I think the China CDC, my friend George Gao, I don't think he was in the know either.
GUPTA: What do you -- what do you mean?
REDFIELD: George really wanted to work, bring in all the power of CDC to work with his CDC to get this done, but he wasn't able. This guy clearly managed at a much higher political level for some reason within China. And I know the president called the president of China to get us in. And you know, I know Secretary Azar called the secretary and the ministry of health to get us in, but the bottom line is we didn't get it.
GUPTA: And a year later, do you have an idea what that reason is?
REDFIELD: I mean, who do you believe, Sanjay, that a year after this pathogen started we're now having a critical analysis of where it came from by scientists. That just seems a little, a little delay. All right? I mean it seems to me that some of the information is people are not being transparent about it. You know, I could use the word cover up, but I don't know that. So, I'm not going to speculate that.
UNIDENTIFIED MALE: Developing this morning, investigators for the World Health Organization had discovered signs that the initial coronavirus outbreak in Wuhan in China was larger than previously thought.
UNIDENTIFIED FEMALE: More questions, fewer answers over the access added data China game to the WHO.
GUPTA: It is becoming increasingly clear that this virus was spreading much earlier than we were alerted.
REDFIELD: As soon as George understood it, we understood it. But what I'm telling you is, I think Wuhan understood it back in the fall.
GUPTA: China has vehemently denied any cover up, insisting that it responded to the outbreak in a transparent and responsible manner. And then a statement out of its Washington embassy has said that the United States is now pointing fingers at other countries.
Now while it is almost impossible to know exactly what would have been different or how many lives we could have saved had our experts been allowed inside Wuhan earlier, what we do know is that it cost us precious time.
REDFIELD: We said, you know, I guess what we need to do is shut down air travel from China, because we don't know who's infected and who isn't.
GUPTA: When I spoke with Dr. Redfield back in February of 2020, the United States was just beginning to acknowledge that community spread of the virus was inevitable. China, by comparison had been well underway preparing for this once in a century pandemic by constructing brand new hospitals that extraordinary speed, and also amassing emergency supplies according to Dr. Robert Kadlec who served as the ASPR, the HHS Assistant Secretary for Preparedness and Response.
KADLEC: They recognize that something was going on in early December, so they had about a 30-day head start to when they publicly announced on 31 December that they had this mysterious pneumonia. And so, they were already buying things on the market well in advance of where we were. So, they make a lot of that material, but even things that were made here in the United States we found that the domestic supplies were drying up because of foreign purchases.
GUPTA: Was China being purposely opaque buying up stuff, not alerting the rest of the world what was going on? What's your impression? KADLEC: I don't want to be an apologist for them, because I think they were less than transparent in January, honestly. But I think part of this is, this was a war that kind of exploded in Wuhan for reasons that are still yet clear to me and basically overwhelm them by their own words.
What happened in Wuhan was transmitted to every province in China within 30 days.
REDFIELD: If I was to guess, this virus started transmitting somewhere in September, October in Wuhan.
GUPTA: September, October?
REDFIELD: That's my own view. It's only opinion. I'm allowed to have opinions now.
You know. I am of the point of view that I still think the most likely etiology of this pathogen and Wuhan was from a laboratory, you know, escaped. Other people don't believe that, that's fine. Science will eventually figure it out. It's not unusual for respiratory pathogens that are being worked on in a laboratory to infect a laboratory worker.
[21:30:05]
GUPTA: It is also not unusual for that type of research to be occurring in Wuhan. The city is a widely known center for viral studies in China, including the Wuhan Institute of Virology, which has experimented extensively with bat coronaviruses.
GUPTA: It is a remarkable conversation I feel like we're having here, because you are the former CDC director, and you were the director at the time this was all happening.
For the first time, the former CDC director is stating publicly that he believes this pandemic started months earlier than we knew and that it originated not at a wet market, but inside a lab in China.
These are two significant things to say Dr. Redfield.
REDFIELD: That's not implying any intentionality. You know, it's my opinion. Right? But I am a virologist, I have spent my life in virology. I do not believe this somehow came from a bat to a human. And at that moment in time, the virus that came to the human became one of the most infectious viruses that we know in humanity, for human to human transmission.
Normally, when a pathogen goes from zoonotic to human, it takes a while for it to figure out how to become more and more efficient in human-human transmission. I just don't think this makes biological sense.
GUPTA: So in the lab, do you think that that process of becoming more efficient was happening? Is that what you're suggesting? REDFIELD: Yes. Let's just say I have coronavirus that I'm working on, most of us in the lab, we're trying to grow virus, we try to help make it grow better and better and better and better and better and better so we can do experiments and figure out about it. That's the way I put it together.
GUPTA: Chinese officials and state media have been increasingly promoting an unsubstantiated so called multiple origin theory, suggesting the pandemic may have started in various locations around the world, even a U.S. military lab and the World Health Organization.
It is called, any lab accident theory, extremely unlikely. But a team of their scientists allowed inside Wuhan more than a year after the outbreak has so far been unable to determine the definitive origin of the virus. And perhaps at this point, many wonder if they ever will.
DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE FOR ALLERGY AND INFECTIOUS DISEASES: So, lessons learned looking forward, we need the WHO, and the world needs an organization that coordinates the global health issues. But they need to reform in a way where they could go in and tell the member state China that you absolutely need to give us this information. And they didn't.
Chinese said, no, we're not going to give it to you. And that was it. With no consequences. And that was, that was not right. And that's got to change.
GUPTA: Next, did we really believe that a contagious virus that was spreading around the world wasn't going to come here?
DR. DEBORAH BIRX, FMR. WHITE HOUSE CORONAVIRUS RESPONSE COORDINATOR: So now you know why I came to the White House.
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[21:35:46]
GUPTA: Back in 2019, you oversaw an exercise known as Crimson Contagion.
ROBERT KADLEC, FMR. ASSISTANT SECRETARY FOR PREPAREDNESS AND RESPONSE: Yes.
GUPTA: In 2019, before the COVID-19 outbreak began, Dr. Kadlec participated in a simulation with local, state and federal authorities designed to assess our preparedness for a potential pandemic.
KADLEC: There were a number of lessons learned, I put them into three bins. The first one is, really the issue of who's in charge, because on a grand scale of something that's happening nationally, conceivably simultaneously across several states, that's really beyond the scope of what HHS has the authorities to do.
The second one is, is really the supply chain, and the stockpile, and our ability in recognizing that there would be a tremendous need for personal protective equipment. And that gets to the third lesson learned, which is money. What money can we scrape up to use to buy things?
GUPTA: Who's in charge? Do we have the supplies we need? And do we have the money? These were the same questions that would come up again in February of 2020. Except this time officials are facing the real thing.
What happened on February 21st?
KADLEC: We had a tabletop exercise. Very serious conversation in the Situation Room, the John F. Kennedy situation room in the basement of the West Wing.
GUPTA: Nearly two months after first learning of the outbreak in China, Health Secretary Alex Azar and Acting White House Chief of Staff Mick Mulvaney led a meeting of cabinet secretaries, staff, and doctors, Kadlec, Fauci, and Redfield to perform an exercise similar to Crimson Contagion, gaming out what might happen, should this new virus turn into a pandemic?
Were there tangible things that came out of that tabletop exercise?
FAUCI: The tabletop exercise said that we're in for a disaster.
KADLEC: And we were beginning to appreciate that there were facets to this disease that didn't comport to what we've ever encountered before.
GUPTA: What was the conclusion? What was the recommendation that was made?
KADLEC: I think the notion was is that, while containment was ideal, in terms of our ability to prevent this from entering our country, it's more likely than not that this virus is already in the United States and we need to be prepared to go to mitigation.
GUPTA: After that tabletop exercise on February 21st, my understanding is that you and your colleagues did want to go and brief the President, talk about this plan, called four steps to mitigation. What happened? Were you able to actually brief the president?
KADLEC: I did not know.
GUPTA: Before the group had a chance to brief Trump, Dr. Nancy Messonnier, Director of the CDC National Center for Immunization and Respiratory Diseases, issued a blunt warning that would infuriate the president.
DR. NANCY MESSONNIER, DIRECTOR, CDC'S NATIONAL CENTER FOR IMMUNIZATION AND RESPIRATORY DISEASES: It's not so much a question of if this will happen anymore, but rather more of question of exactly when this will happen. We are asking the American public to work with us to prepare in the expectation that this could be bad.
[21:40:13]
BIRX: I think when Nancy said what she said, I knew she was seeing what I was seeing. She got moved aside because of saying that
REDFIELD: I supported her, I thought, you know, that she was being prophetic about how we have, we would have to get prepared, life would change.
UNIDENTIFIED FEMALE: CDC said yesterday that they believe it's inevitable that the virus will spread in the United States and it's not a question of if but when, do you agree with that assessment?
DONALD TRUMP, FORMER PRESIDENT OF THE UNITED STATES: Well, I don't think it's inevitable. I probably will, I possibly will. It could be at a very small level or it could be at a larger level. Whatever happens, we're totally prepared.
FAUCI: Nancy got pushed back a lot because of that. When she was right on the money, she hit the nail right on the head.
TRUMP: I'm going to be putting our Vice President, Mike Pence, in charge.
GUPTA: When you heard that the vice president was going to be in charge of the task force, what do you think?
FAUCI: I thought that was a good thing because I thought it was going to elevate it so that we can get the attention, you know, of the powers that be.
TRUMP: Mike is going to be in charge and Mike will report back to me.
MIKE PENCE, FORMER VICE PRESIDENT OF THE UNITED STATES: We authorize that, right?
UNIDENTIFIED MALE: Correct.
GUPTA: Pence's appointment finally answered that first critical question from Crimson Contagion, who's in charge. But with an important caveat, unlike other government officials who handled health crises in the past, as vice president there was a different level of accountability because he could not be fired if he failed to perform. But someone who could be fired the new coordinator for the White House COVID task force.
PENCE: She will be my right arm through this. And I'm grateful that Ambassador Deborah Birx, also Dr. Deborah Birx will be on our team.
BIRX: In March when I arrived, I spent the first week really trying to get some lay of the land.
TRUMP: The risk to the American people remains very low.
BIRX: So, first I wanted to make sure that we stopped saying that the risk to Americans was low because I could see we were not going to be different than Europe. We were going to have the same problem.
PENCE: The risk to the American public --
REDFIELD: Is low.
PENCE: -- remains low.
FAUCI: The risk is low.
GUPTA: Why were we still saying the risk to Americans is low at that point? Did we really believe that a contagious virus that was spreading around the world wasn't going to come here?
BIRX: So, now you know why I came to the White House, because I could see the avalanche coming and I could see that we were not prepared. And I thought I could do something.
But when I arrived that Monday morning, I was like, we have to do these three things, we've got to get the testing people and we got to get the treatment of vaccine people, and we have to really talk to the medical correspondence because community has to understand we won't make any progress unless the American people really understand all aspects of this so they can interpret it and apply it to their lifestyles because it has to be real to them.
And the vice president did all those things that first week. I don't know why he listened to me because we had no prior relationship, he did not know me. Clearly, some of his office did not support me being there.
GUPTA: What do you mean?
BIRX: There was a group that really believe this wasn't as big a deal as we were making it and there was another group -- and then impacting people's livelihoods for not a really good reason. And then there was the other group that just was more fatalistic, that no matter what we did the outcome was going to be the same.
GUPTA: Making an unseen threat real to the American public was difficult enough, but especially when those in charge according to Dr. Birx hadn't fully grasped the extent of the risk either.
BIRX: No time that anyone in the White House give me the opinion that any of them thought that there was significant asymptomatic spread. I don't think the doctors actually new.
GUPTA: Critics say that even the CDC, the nation's premier health institution was too slow to recognize the threat as well.
REDFIELD: One of the things I was most surprised when I became CDC director of how many of the core capabilities of CDC of public health didn't exist, data management, predictive data analysis, data analytics, it didn't exist. Some health departments are still using fax machines.
DR. BRETT GIROIR, AMERICAN PEDIATRICIAN: It's really our job to make sure that the public has the best information.
[21:45:04] GUPTA: Dr. Brett Giroir began his career as a pediatrician, but spent years studying pandemics and leading vaccine development at Texas A&M. In 2018, he was named the top medical and science adviser to HHS Secretary Alex Azar.
GIROIR: I love the people at the CDC. But as an organization, it was not built for operations, right? It's much more of an academic Think Tank. It really is not meant to be a fully operationalized organization that can scale with the private sector and really work with hospitals in the private industry the way we needed to.
GUPTA: The nation's federal pandemic infrastructure was not prepared for the crisis that was quickly unfolded. Our public health data system, not prepared, our emergency stockpile supplies, not prepared. The supply chain itself, all of it unprepared.
KADLEC: When we started the pandemic in January, we really didn't know what the status of the supply chain was. We didn't know what hospitals had on hand. We didn't know what the state supplies were. We didn't even know what the commercial distributors had on their shelves. And we didn't know what was in the manufacturer warehouses.
GUPTA: Why did we know that?
KADLEC: Well, because there was no need to know that, right? We had a just in time supply chain.
GUPTA: Amid January, your team at HHS dropped contingency plans to enforce the Defense Production Act?
KADLEC: Yes.
GUPTA: The Defense Production Act gives the federal government power to expedite and expand manufacturing by U.S. industries for the national defense.
So what happened there? It wasn't ultimately signed or in acted until sometime later.
KADLEC: Well, the thing is, is that in order to invoke the Defense Production Act, you have to basically have a contract. That didn't happen until April, because we didn't get our money till March. We only be prepared for the amount of money that we had.
GUPTA: Dr. Kadlec, who oversaw the National Stockpile in his role at HHS, has come under fire by a whistleblower complaint filed by former HHS scientist Rick Bright, who alleges, in part, that his boss, Dr. Kadlec and others at HHS, were slow to recognize the pandemic threat in it's early days.
KADLEC: I would say I would challenge some of the accuracies of his complaint.
GUPTA: I think the sort of narrative that he was painting was that he was the one that was sounding the alarm and nobody was listening. And you, others, did not see the urgency that he did. KADLEC: Well, I had the urgency. I mean, there's no doubt I had the urgency. And again, he was one of many voices that I listened to, to basically said, what do we need to do?
PENCE: I'm going to ask Admiral Brett Giroir, of the Public Health Service, leader of this great commission corps behind me to come up --
GUPTA: When you walk into this pandemic, how far behind you think we were at that point?
GIROIR: We had no systems in place. The way to find out how many ventilators are being used is to call up and see, well, who are the manufacturers? We don't know.
What's a supply chain? We don't know. How about tubes of transport media? Never heard of them before.
How many tests do we have in the stockpile? Well, there was no test in the stockpile. How many swabs do we have? We didn't have a single swab. So, all of this was starting from scratch.
GUPTA: Coming up, what went so wrong with testing,
GIROIR: I really felt that we were starting at point zero back then, that we were really unprepared.
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[21:52:10]
GUPTA: Testing, many would argue it is the original sin of our COVID response. The age old trap of too little too late from the now infamously flawed CDC tests to Trump's false pronouncement that anybody that wants to test can get a test. And these problems started from the very beginning.
In January of 2020 well before COVID-19 was designated a pandemic, weeks before the United States had their own test, there was already a test available to diagnose the novel virus.
The World Health Organization, the WHO had a test that was pretty good, 95 percent sensitive.
GIROIR: Yes.
GUPTA: That was January 17th data. Was using those tests a consideration for the United States?
GIROIR: I can honestly tell you I don't know. I think that's something to ask Dr. Redfield or someone who is involved at, you know, at that point.
REDFIELD: In order for us to use it, the FDA had to review it, but I can tell you that it wasn't available in the United States, so maybe Steve gave you a different answer. DR. STEPHEN HAHN, FMR. FDA COMMISSIONER: Yes, I don't know who the WHO would have reached out with respect to that, to that test. I wasn't aware that WHO reached out to FDA or had submitted data.
GUPTA: The WHO told me, the United States never asked to use its test.
UNIDENTIFIED MALE: No, we did not offer the test the U.S., which will be standard practice if we were asked obviously. We would have -- we would have that responded.
GUPTA: Was it a mistake not to use those tests?
BIRX: It was a mistake not to use everything that we had and every tool.
GUPTA: Confident in their own abilities, the CDC chose to develop and distribute its own test, a decision that would come to haunt the agency and its director.
UNIDENTIFIED FEMALE: Early coronavirus test kits may have been contaminated, leading to a possible delay in the CDC's ability to get those kits to health labs.
REDFIELD: Within about five weeks with the FDA's agreement, we got all of the public health labs in this nation to have an effective test.
GUPTA: So, about five weeks?
REDFIELD: Probably about five weeks, it took -- correct. Yes.
GUPTA: Five weeks, which many have called the lost month when COVID-19 spread across the United States, mostly undetected.
REDFIELD: I was not a happy camper that CDC decided to manufacture test. We're not a Manufacturing Corporation. The private sector was supposed to work with the FDA to develop that.
[21:55:09]
GUPTA: But the FDA added another step to the process. They asked labs to apply for an emergency use authorization or EUA to bring their test to market during a public health emergency. Something many labs never had to do before.
HAHN: The declaration of public health emergencies allows us to use our emergency use authorization authority, that allowed us to use a different, if you will, evidentiary standard and regulatory standard to authorize products.
GUPTA: That did inhibit the private sector from coming in and the academic sector from coming in, because that's not something they really were used to.
GUPTA: We heard this over and over again, we've got this great alternative, we can't get the FDA to pay attention, was that -- were those fair criticisms? HAHN: Upwards of 60 percent of the tests that we reviewed had problems with them. And so, the question is, do you want tests that are on the market just so you can get tests on the market? Or do you want there to be some oversight to ensure that the specificity and sensitivity and the accuracy is appropriate?
GUPTA: In the meantime, in addition to that WHO test, other countries were now successfully deploying tests of their own, and the United States was falling further and further behind.
UNIDENTIFIED FEMALE: -- administration is only testing of less than 500 people and health officials are questioning whether that's enough?
TRUMP: Well, we're testing everybody that we need to test. And we're finding very little problem.
HAHN: We have received a lot of comments from folks in those laboratories that the process was slow. And it was at that point that we decided to revise, to do allow them to go to market without authorization.
GUPTA: The FDA did revise their rules. But it wasn't until mid-March that the EUA requirement was dropped entirely. Right as infections in the United States began to spike and you confirm cases in those countries with aggressive testing began to fall.
UNIDENTIFIED FEMALE: We're seeing a decrease in cases across Asia, what we know works is testing.
GUPTA: Testing worked, but only if you were testing the right people, both people with symptoms, and without.
REDFIELD: The only way we're going to know what this virus is, is if we test people. And at the time, we were still thinking we didn't need that because we could pick out people with symptoms.
FAUCI: In the spirit of post mortem without pointing any fingers, the stance we took was you test somebody who's symptomatic, and not everybody who wants to test should get a test, only those who need a test.
REDFIELD: And we were wrong.
GIROIR: The priorities for testing and who we recommended to be tested directly match with what our capabilities were, right? And that's just a fact. March 4, we're talking about 75,000 tests available in the entire United States, OK, from one source.
TRUMP: Anybody that wants to test can get.
GUPTA: The President's remarks two days later on March 6, simply weren't true. Making it more apparent than ever, that someone needed to take charge of the nation's testing.
REP. DEBORAH WASSERMAN SCHULTZ, (D) FLORIDA: We need to have someone in charge of making sure that as many people as possible across this country have access to getting tested as soon as possible. Who is that person? Is it you? Is that the vice president?
R:As I tried to explain to Congress --
GUPTA: His answer was, I really don't know. It was the next day essentially that you were appointed, the testing czar. Three months into things or, you know, middle of March now timeframe, it's basically been declared a pandemic at this point. Why are there hardly any tests out there? Why at that point?
GIROIR: So, of course, I asked myself that question a lot. And my best answer is a few different answers.
PENCE: Over a million tests have been distributed before the end of this week and other 4 million tests will be distributed.
GIROIR: When we said there were millions of tests available, there weren't, right? There were components of the test available, but not the full meal deal.
None of these things really worked in a vacuum. They needed to be brought together in a reasonable way. And it seems like such a small thing. But if you don't have that kind of coordination put together, it doesn't get done.
GUPTA: Coordination, though, was far from the only fundamental issue. According to the doctors. It was the administration's overall attitude toward testing as well.
BIRX: People really believed in the White House, that testing was driving cases, rather than testing is a way for us to stop cases.
TRUMP: If we didn't do any testing, we would have very few cases.
BIRX: Test thing was this Flashpoint. It continued to be a flashpoint.
