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CNN Special Reports

CNN Special Report, COVID War: The Pandemic Doctors Speak Out. Aired 10-11p ET

Aired March 28, 2021 - 22:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

[22:00:00]

DR. DEBORAH BIRX, FORMER WHITE HOUSE CORONAVIRUS RESPONSE COORDINATOR: Testing was this flashpoint, it continued to be a flashpoint. I think that's why Scott Atlas was so powerful when he came into the White House because he really didn't believe in testing for asymptomatic cases.

DR. SCOTT ATLAS, FMR. SPECIAL CORNAVIRUS ADVISER TO TRUMP: Thank you, Mr. President.

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT (voice-over): Dr. Scott Atlas joined the Trump administration as a special adviser on COVID in August, a concerning choice given that Atlas is not an infectious disease expert. His specialty is in diagnostic radiology. Dr. Atlas had already made his controversial views on testing clear even before arriving at the White House.

ATLAS: There's absolutely no reason to require massive widespread testing.

GUPTA: Just weeks after his arrival and months into the pandemic, the CDC reversed their guidance to exclude most asymptomatic testing.

ALISYN CAMEROTA, CNN ANCHOR: The agency now says that people exposed to coronavirus may not need to be tested.

DR. ROBERT REDFIELD, FMR. CDC DIRECTOR: Once I saw it and saw how it was being interpreted i made sure it was changed because it was not the message the CDC was going to put out and wasn't the message I was going to put out. And as you know that's why I'm changed that guidance.

GUPTA (on camera): Was there pressure on you or on the organization to put out a message like that?

REDFIELD: I wouldn't say there's pressure but, you know, I've been silent about my points of view that Dr. Scott Atlas his perspective was in my view allowed him to ill-inform a lot of people and as a consequence kind of negated the Dr. Birx's, Dr. Fauci's, Dr. Redfield's, Dr. Hahn's voice and the highest level is government.

BIRX: I told people I would not be in a meeting with Dr. Atlas again. I felt very strongly that I didn't want an action that legitimize in any way his possession. ATLAS: Total population isolation is actually preventing the development of herd immunity where the actual network of infection can be blocked protecting the vulnerable.

GUPTA: When Scott Atlas said hey you know I think herd immunity in certain populations may be the way to go. I mean what were those conversations like then?

DR. BRETT GIROIR, FMR. ASSISTANT SECRETARY FOR HEALTH, HHS: They were pretty heated because it is clear that Dr. Atlas's position is that we should just sort of let it go in the healthy population to create herd immunity, that is not up for question.

Day one when he showed up that was very clear it was written as his view. The subtlety here though his key thought is you could protect the vulnerable and let sort of the well build up this herd immunity and Dr. Birx and I and the rest of the doc said this is a fallacy, right.

BIRX: It was a community spreading event and there was no way to ring fence vulnerable Americans. They truly believe that that was possible.

GUPTA (voice-over): CNN reached out to Dr. Scott Atlas for comment on the doctors views, but he never responded.

We were not testing enough?

REDFIELD: Agree with you.

GUPTA: Or we're still not testing enough?

REDFIELD: I agree with you. I told you.

GUPTA: Why not though?

REDFIELD: Well, I think people have been talking about how many tests we have rather than sitting back and saying how many tests we need. We need to be doing about 5 million tests a day to get testing positioned as a critical part of the mitigation plan.

BIRX: You know obviously we started very late. I think they'd worked very hard to bring testing up but we were always behind the testing.

GUPTA: When we come back, the clash between science and politics.

DR. STEPHEN HAHN, FMR. FDA COMMISSIONER: Masks should have never become a dividing line in our country.

(COMMERCIAL BREAK)

[22:07:27]

GUPTA: As scientists around the world work day and night to create a vaccine for COVID-19, there were already simple things we could do to slow the spread of this insidious virus, wear a mask, wash our hands, physically distance. The same things we did more than 100 years ago, the last time a pandemic this deadly ravaged the world. But just like back then some of us chose not to in a country of plenty, we too often wait for science to rescue us to pull us out of the fire but the better choice preventing the fire in the first place.

DONALD TRUMP, FMR. PRESIDENT OF THE UNITED STATES: My administration is recommending that all Americans including the young and healthy work to engage in schooling from home when possible, avoid gathering in groups of more than 10 people.

DR. ANTHONY FAUCI, CHIEF MEDICAL ADVISOR TO PRESIDENT BIDEN: We gave the strong recommendation that we really shut things down as best as we can.

GUPTA: How hard to sell was it?

FAUCI: Well you know we were sitting around the resolute desk talking to him about it and I thought that he accepted a pretty well. I really did.

GUPTA: Our government is prepared to do whatever it takes whatever --

BIRX: I think that at that moment in time the White House believe that this was serious and I think part of what drove that is the president's understanding that he had friends dying part of that understanding was seeing Elmhurst Hospital and understanding that that was could be repeated in 6, 000 hospitals around the United States.

FAUCI: When you saw it how much that exploded in a way that we've never seen before but didn't just explode with the number of cases but almost overrunning of our healthcare system.

GUPTA (voice-over): In the face of the unimaginable the doctors devised an unprecedented 15-day shutdown plan which ultimately expanded into 45 days. It was the doctors attempt to flatten the curve to prevent a surge in hospital cases and to buy us some time to answer the inevitable question.

FAUCI: Now what are we going to do we can stay shut forever so let's open up, but if you want to open up you better open up carefully. You got to have 14 days of coming down in the slope and you go to phase one then you have another number of days coming down on the slope. You may have some blips but in general the trend has to be down and that's how you wind up trying to open up.

[22:10:04]

BIRX: If you look at that opening criteria, it was written and gamed out, so that no state could really make it through all of those gates before August, which I, in my mind thought of this give us enough time to really get testing and PPE and everything that we needed together.

FAUCI: That's not what happened.

BIRX: States that have been very good about the 45 days to slow the spread, then completely ignore the opening criteria. I didn't see coming that no one would follow really the gating criteria, including the average American so when Memorial Day came, it was -- it was shocking.

FAUCI: That's when I believe there was really a problem. Some tried to do it right. But the constituents in the state didn't hardly pay any attention.

UNIDENTIFIED FEMALE: COVID is a fraud. It isn't a pandemic.

FAUCI: I got a reputation on the outside of not caring about the economy only caring about the public health. But no, I didn't want to see the country go down the tubes. But I also was very adamant that if we did it correctly, that we could open up the country and open up the economy and still not have a soaring of cases.

UNIDENTIFIED FEMALE: I don't want to get emotional, but we have had enough. We have to support our families.

UNIDENTIFIED MALE People are hurting, people are hungry. It's ridiculous.

GUPTA (on camera): Other parts of the world seem to have done a lot better. Was that a uniquely American problem? Why did this happen here versus other places around the world?

BIRX: So I was in Asia during SARS. I could see the population move as one in many of the Asian countries. Within minutes of the SARS pandemic, every single shop in the Narita terminal had masks on, they had the experience of masking entire society because of SARS, they were ready. And they moved as one.

GUPTA (voice-over): Mirroring our politics, conspiracies about the shutdown multiply.

UNIDENTIFIED MALE: This pandemic was designed to depopulate crush small businesses and the economy.

GUPTA: And as the protest grew, the president chimed in.

TRUMP: Our country was in built to be shut down.

FAUCI: The thing that hit me like a punch to the chest was then all of a sudden he got up and says liberate Virginia, liberate Michigan and I said to myself, Oh my goodness, what is going on here? That shocked me because it was such a jolt to what we were trying to do.

BIRX: Now one policy directive he gave to me in April, was the last time I really had any briefing with him and that kind of way was we will never shut the country down again.

GUPTA: Compounding the growing backlash against the doctor's recommendations to stay home was a stark reversal and guidance from the CDC on an issue bizarrely politicized more than any other in this pandemic, masks.

ANA CABRERA, CNN ANCHOR: The CDC is now recommending the use of face coverings when any of us goes out in public.

GUPTA: For several weeks, the doctors had been advising Americans not to wear masks.

REDFIELD: We do not recommend them to be used by the general public.

FAUCI: People should not be walking around with masks.

GUPTA (on camera): By March 8, you told 60 Minutes, you are not recommending masks for everyday Americans. We know it's spreading in communities, we know it's spreading asymptomatically Why not masks at that point?

FAUCI: We were told at the level of the Task Force, that we have a real shortage of masks. So we don't really want the whole country going out and trying to use up all the masks, our health care providers who are putting themselves in danger every day of taking care of people who you know are sick. We don't want them to go without masks.

So what changed, A, all of a sudden there was no shortage because you could get a cotton mask and you could put it on and you could be protected. Number two, we didn't know that cloth masks work. The third thing it became eminently clear that asymptomatic people were spreading infection.

TRUMP: The CDC is advising the use of non-medical cloth face covering.

GUPTA (voice-over): The same day the CDC began recommending masks. The President publicly dismissed them.

TRUMP: I don't think I'm going to be doing it.

GUPTA: And would continue to mock them throughout the campaign season.

TRUMP: I wore one in this back area. But I didn't want to give the press the pleasure of seeing it.

Maybe they're great and maybe they're just good, maybe they're not so good.

[22:15:05]

GUPTA: In fact, it was just the opposite. New studies revealed that masks and specifically double masking could prevent the spread of COVID-19 by upwards of 90 percent. But even after contracting the virus himself, the President was often seen without one of our most powerful tools at that time to stop it.

HAHN: Masks should have never become a dividing line in our country.

UNIDENTIFIED MALE: I mean, if he's not wearing a mask, I'm not going to wear a mask. And he's not worried. I'm not worried.

UNIDENTIFIED MALE: The president.

UNIDENTIFIED MALE: Yes, sir.

UNIDENTIFIED MALE: With violation, my constitutional rights, and my civil rights.

FAUCI: The divisiveness in our society that prevented us from attacking a common enemy in a common way. And the enemy was the virus. But it seemed that we in our own country were fighting with each other, instead of fighting with the virus.

GUPTA (on camera): And I have to tell you, when we last met, in November, at the White House, this is post-election, the President, members of his family and people within the White House had been infected with the virus. And I was so struck inside at the White House at that time, how few masks I saw, did it strike you?

BIRX: Oh, that was my world every day, there was a feeling in the White House from the beginning. And I don't know if this is true or not, because I never confronted the president because I didn't have access to him by that time, that the President was not supportive of mass squaring in the White House. And that trickle down through every single leader.

There was one event in the Rose Garden, it was made clear that they didn't want us wearing mask. And so all of the cabinet officials, and even some of the military members took their mask off. Dr. Fauci and I did not and you can see we are way in because they didn't want us front and center. And masked.

GUPTA: You were the COVID coordinator and no one's -- no one around you is wearing masks. That must have -- that must have felt like you were being marginalized, that people really weren't listening to you.

BIRX: I was marginalized every day. That is no question. I would say majority of the people in the White House did not take this seriously.

GUPTA (voice-over): Next.

HAHN: That was a line in the sand for me.

GUPTA: The doctors are pushed to their limits.

REDFIELD: And I finally had a moment in life where I said you want to fire me fire me and that's enough.

(COMMERCIAL BREAK)

[22:21:06]

GUPTA: Scientists and doctors like to consider themselves above the political fray, immune to the whims of whichever party may be in power. The reality is far more complicated particularly during a pandemic. This past year if anything has revealed the high price we all pay when science and partisan politics collide.

GUPTA (on camera): So when did you officially take the job as commissioner? HAHN: The 17th of December, 2019

GUPTA: Heck of a time to become the FDA commissioner.

HAHN: For sure.

GUPTA: Six weeks after you formally take the job, secretary of health declares a public health emergency. How worried were you?

HAHN: Well, I was substantially concerned. I don't think any of us understood the magnitude of the response that would be necessary.

GUPTA (voice-over): Dr. Stephen Hahn like many of Trump's appointees was a Washington outsider, a medical and radiation oncologist. Hahn was most recently lauded for his role as top medical official at the renowned Texas cancer hospital MD Anderson. However his critics warn that Hahn's lack of policy experience pose some serious challenges for a critical role that requires deft political savvy.

(on camera): President Trump began touting hydroxychloroquine back in March.

TRUMP: And you have hydroxychloroquine and I think it's going to be very exciting. I think it could be a game changer.

GUPTA: After he was talking about you came up right after that and explained the clinical trials were going to be needed.

HAHN: We want to do that in the setting of a clinical trial, a large pragmatic clinical trial to actually gather that information and answer the question that needs to be asked and answered.

GUPTA: Just nine days later on March 28, the FDA issues and emergency use authorization for hydroxychloroquine. Do you think you would have done the same thing if President Trump wasn't touting hydroxychloroquine the way that he was?

HAHN: Given the publicity around hydroxychloroquine, if there hadn't been that publicity, the need in terms of the stress on the system and the shortages of the drugs wouldn't have been there.

GUPTA: Risk reward, that's the metric that you use for EUA.

HAHN: Ultimately.

GUPTA: Was the risk higher than the reward with that EUA for hydroxychloroquine?

HAHN: Well, clearly we didn't think that initially because we made the decision to go forward with the EUA.

GUPTA: Do you have no basis to say that the reward was going to be greater than the risk. You yourself said we need to study this.

HAHN: So with anything use the data at the time and as you know the Center for Drug Evaluation Research used published article that was performed Phase 2 trial with respect to hydroxychloroquine that should benefit hospitalized patients it formed the basis for that risk reward assessment plus the 30 years of experience with the drug.

TRUMP: A lot of good things have come out about the hydroxy. A lot of good things have come out.

GUPTA (voice-over): President Trump even called it --

TRUMP: A gift from heaven.

HAHN: He was convinced that that would work.

GUPTA: But it didn't work and the FDA revoked the EUA for hydroxychloroquine two and a half months after it was first authorized. Their scientists I concluded that the drug was unlikely to be an effective treatment for COVID-19 and was even tied to serious cardiac events, risk higher than reward.

(on camera): You think people were hurt because of that EUA?

HAHN: We sent out a safety alert I think sometime in April or May regarding the potential for increased risk of heart side effects, but I do believe that once we collected the data and had the information that we made the appropriate decision and revise that based upon the data we had.

GUPTA: You have had a year now roughly to reflect on that, was it the right decision?

HAHN: I think it was the right decision at the time. I also think that the revocation of that EUA was the right decision.

GUPTA: What is the lesson?

HAHN: Well, you know, I think my lesson from that is that the discussion around medical interventions for a public health emergency are best held by medical experts.

[22:25:12]

TRUMP: Next. Next please.

HAHN: When the President from whatever podium is at, talked about a therapeutic or some medical intervention. That became a political football, frankly, and it was an unfortunate situation.

ALEX AZAR, FMR HHS SECRETARY: And I'll turn it over to Dr. Hahn, if it's OK, Mr. President.

GUPTA: What was your relationship like with Secretary Azar?

HAHN: Strain. There were certain situations where we had basic disagreements and laboratory developed tests as a perfect example.

GUPTA (voice-over): In August, after months of debates surrounding the FDA his role in approving new COVID-19 tests, Secretary Azar revoked the agency's power to regulate lab develop tests.

HAN: That was a line in the sand for me because I knew that this oversight was important. And I knew that the FDA stamp of approval meant something. It was reported in the press that we had a shouting match, and I can 100 percent assure you they did I did not shout and scream at the secretary of Health and Human Services.

GUPTA (on camera): Did he shout to you?

HAHN: You should ask him that question.

GUPTA: If the secretary of health is screaming at the FDA Commissioner in the middle of a public health emergency, that's a problem.

HAHN: Yes, there was definitely that sort of pressure, Sanjay, I, you know, it's true. At the end of the day, someone's trying to ask me to do something that I don't think is right. And my patient, the American people need something different.

GUPTA (voice-over): Former HHS Secretary Alex Azar told us in a statement that quote, FDA is illegal assertion of jurisdiction over common lab developed tests slow the development of U.S. COVID testing, and that Dr. Hahn's recitation of this call is incorrect. The only intemperate conduct according to Azar was Dr. Hahn's threat to resign. Dr. Hahn told CNN, he never threatened to resign on the call.

REDFIELD: I had really had dreams that he was going to be unbelievable that you don't have a great relationship with the secretary. He would have total confidence and just let me run CDC. Unfortunately, that's not the deal I got, but I don't think that's the deal Hahn got either.

And a lot of people think the challenges that the CDC director, me had, were with the White House. I didn't have really very difficult challenges with the White House. The challenges I had with the Office of Secretary.

GUPTA (on camera): What would happen?

REDFIELD: I think some of the ones that were the most notable that I was the most offended by was the calls that wanted me to pressure and change the MMWR.

GUPTA (voice-over): The MMWR is the Morbidity and Mortality Weekly Report, a CDC published roundup of important research on death and disease, as well as recommendations. It is highly revered in the world of public health. Doctors and scientists of all stripes rely on these reports to inform their decisions, often decisions of life and death.

REDFIELD: I was on more than one occasion called by the Secretary and his leadership directing me to change the MMWR. Now he may deny that but it's true. The one time that was the most egregious was not only once I pressured by the Secretary in his office, and his lawyers, as I was driving home, his lawyer and his chief of staff called and pressured me again, for at least another hour, even to the point of like accusing me of failing to make this change that would cost you know, thousands of lives. And I finally had a moment in life where I said, you know, enough is

enough. You know, if you want to fire me, fire me. I'm not changing the MMWR.

GUPTA: The former Secretary declined our request to be interviewed, but provided a statement, which states in part that quote, any suggestion that I pressured or otherwise asked Dr. Redfield to change the content of a single scientific peer reviewed MMWR article is false.

In a separate statement, Azar's former Chief of Staff, General Counsel and other senior staff members also pushed back at Redfield's account, stating in part that, quote, Secretary Azar and his immediate staff always regarded the MMWR as sacrosanct.

(on camera): I am struck because I hear about things that have happened in United States and I think those sorts of things that happen in other countries, they don't happen here. And then you describe a situation like this. That's the United States. It's hard to believe.

REDFIELD: Yes, it was hard. But you one thing you'll know about me, Sanjay, is I spent 23 years in the military. I am a command chain kind of guy. And if I can't stay in the command chain, then I'm going to leave. And I'll decide to stay in the command chain as long as I think I still have value for the nation. And that's what I did.

[22:30:00]

GUPTA: After the break. What happened?

DR. DEBORAH BIRX, FRM. CORONAVIRUS RESPONSE COORDINATOR: I got called by the President.

GUPTA: Another autopsy lesson. Were you threatened?

(COMMERCIAL BREAK)

GUPTA (voice-over): Years ago while in residency training to become a surgeon, a favorite professor of mine told me something I'd never forget. I was on call for the first time. And as he was leaving me alone in the hospital he said, call me if you need me. But if you do, it will be a sign of weakness.

Through the years, I've thought a lot about that conversation, what it said about him about our profession, and mostly about leadership, the delicate balance of strength and humility, especially in a time of crisis. Which brings us to our final lessons.

(on camera): This is a novel Coronavirus. How do you make big decisions in the face of so little known and so much uncertainty?

DR. ANTHONY FAUCI, CHIEF MEDICAL ADVISOR TO THE PRESIDENT: You do it with trying to grasp as much data as you can within that really limited timeframe. Use experience and then maybe some good judgment but there's a day you're there because if you are in it things are going to change

[22:35:08]

GUPTA: Dr. Fauci has seen quite a bit of change in his career. President Biden is now the seventh president, he has advised, seven very different leaders.

FAUCI: But a very good friend, and he knew me well. And what he said was, do yourself a favor. Every time you go into the White House, whisper to yourself. This may be the last time I'm walking into the White House. I took his advice. I get it with Clinton. I get it with George W. Bush. I did it with Obama. And I did it with Trump.

The only trouble is with Trump had became much more dramatic. Because I literally had to get up and directly contradict something.

No, the answer is no.

And that was something that, you know, we know the story of that.

DONALD TRUMP, FMR. PRESIDENT OF THE UNITED STATES: Don't tell anybody but let me wait till a little bit after the election.

DR. ROBERT REDFIELD, FMR. CDC DIRECTOR: Some people, I think, give the idea that somehow, you know, in that environment, there was a lot of pressure, not to say what you had to say, that may be true for a number of people. I didn't experience at that at that level.

Well, I think I first I want to thank you for your decisive leadership, and helping us, you know, put public health first.

GUPTA: That CDC tour you heard the President say --

TRUMP: Anybody that wants to test and get a test.

GUPTA: You knew that wasn't true. You also praised him.

REDFIELD: Well, I praised him for leadership in his decisive leadership in shutting down air travel to China, which I did feel was a decisive decision which having been in the room, there was a lot of pushback. That's not to say, I praised him for decisive leadership across the board.

But I would like to say that I found the President to listen to what I had to say, really listen.

TRUMP: So I'll ask Dr. Redfield, who is a real professional to come up and explain, please.

GUPTA: Did you feel you're prepared to take this job as head of the CDC?

REDFIELD: Thank you, Mr. President.

Yes, I did. I think that I know there are some that may not have felt that but yes, I think I trained my whole life for this. TRUMP: You want to respond to that? If you have the numbers?

BIRX: Sure, I have the numbers.

People have had a lot of perceptions of me, they made that very clear. I understand that. Did I handle it perfectly? I am sure I did not. Our federal messaging was not consistent. I heard it from every state of how important the president and vice president messaging was, and how critical it was to get them on message. I was not capable of keeping the White House on a message.

But I will tell you, when I sat with the Vice President and said to him with these kinds of curves, it's going to be worse than anything we have seen before. And I can't carry the message that the White House is carrying right now. And he looked at me and he said, You do what you need to do. To me that was permission to really take the message that I needed, and people should know, I flew to these places on his plane. That's why we developed the whole state level strategy.

FAUCI: Deb would be with her suitcase, getting on a plane and visiting everybody, I would be constantly on the phone with governors and mayors talking about what they need to do.

BIRX: I would be allowed to be very frank.

This is the least use of mass that we have seen.

And fact facilitated, to be frank with regional and local press and governors and mayors and be very clear about mass mandates and closing bars and severely restricting indoor dining and all of these elements, that I was never allowed to say nationally.

GUPTA: Were you being censored?

BIRX: Clearly someone was blocking me from doing it. My understanding is I could not be national, because the President might see it.

FAUCI: No, I don't want to get into rehashing the White House situation. But I can say without hesitation that the Vice President is a really a good, good person, a good human being and he really tried to get a good discussion around but the discussion, you know, it never got to the point where there were things that needed to be done that got up and were agreed upon right up the chain.

REDFIELD: For me, he provided me the only support I got from anybody in leadership.

MIKE PENCE, FMR. U.S. VICE PRESIDENT: Let me yield to the expert.

[22:40:05]

GUPTA (voice-over): But ultimately the leadership the doctors needed, and that Americans were depending on was from the President himself.

TRUMP: People are tired of hearing Fauci and all these idiots. We're rounding the turn. They hate it when I say it. GUPTA: But no matter what the Task Force did were said, after that initial shutdown in March, Trump's public message never fully aligned with the doctors again.

BIRX: I knew I was being watched. Everybody inside was waiting for me to make a misstep. So that they could, I guess, remove me from the Task Force.

It is extraordinarily ride, spread the CNN report, and August that got horrible pushback.

Everybody who lives in a rural area, you are not immune or protected from this virus.

That was a very difficult time, because everybody in the White House was upset with that interview. And the clarity that I brought about the epidemic.

GUPTA: (on camera): I can tell just by reading your face, that was a really tough time. What happened?

BIRX: Well, I got called by the President.

GUPTA: What does he say?

BIRX: Well, I think you've heard other conversations that people have posted with the President. I would say it was even more direct than what people have heard. It was very uncomfortable, very direct, and very difficult to hear.

GUPTA: Were you threatened?

BIRX: I would say it was a very uncomfortable conversation.

GUPTA: I think the idea that people may have been muzzled when you're in the middle of the biggest public health crisis of our lifetime is really concerning. Does he threatened me?

BIRX: He felt very strongly that I misrepresented the pandemic in the United States, that I made it out to be much worse than it is. I feel like I didn't even make it out as bad as it was. I mean, there was a lot of parts of the United States that weren't prepared. There was a lot of anti-maskers, there was a lot of COVID deniers, and I was worried that the virus would intersect with that.

GUPTA: For you, what is the lesson learned here, then? How much of this was because of the lack of a national message national leadership on these issues?

BIRX: Absolutely key. I mean, the federal government did not provide consistent messaging to the American people. And that is follow-up number one.

GUPTA (voice-over): When we returned, the conclusion of our COVID autopsy.

FAUCI: This is a war.

GUPTA (on camera): What was the biggest failure?

(COMMERCIAL BREAK)

[22:46:30]

GUPTA (voice-over): A staggering one in three Americans has now lost someone to COVID-19 according to a recent survey, one in three. It's a painful reality that is solidified this pandemic is one of the deadliest chapters in American history.

But what is still yet to be written is what we do next. Will we as a nation heed the lessons of our own failures? Or will we wait and continue to hope and pray that science will somehow be there again eventually, to rescue us?

UNIDENTIFIED MALE: Drugmaker Pfizer is reporting that early data from its vaccine trial has shown it to be 90 percent effective. Dr. Anthony Fauci --

GUPTA: Mr. Bourla, are you there? Welcome.

Dr. ALBERT BOURLA, CHAIRMAN AND CEO, PFIZER: Hello, Dr. Gupta.

GUPTA: Congratulation --

FAUCI: I get a call on my cell phone. And it's Albert Bourla. He said, Tony, are you sitting down? And I said, Yes. And he said, it's more than 90 percent. And I got to tell you, he was like, Oh, my God, it was just like this emotional catharsis. And then a week later, Moderna got exactly the same results. It was like, beyond your expectation.

BIRX: You don't always get a homerun in science. The mRNA vaccine is a homerun. It is a homerun from the standpoint of how quickly and how excellent and how well the trials were done.

GUPTA: But even with the home run in hand, some of the same pressures that plagued the doctors' efforts throughout the response, were also threatening their greatest success.

TRUMP: We're very close to that vaccine, as you know, and I think closer than most people want to say, or certainly closer than most people understand.

GUPTA (on camera): How did that translate to you?

DR. STEPHEN HAHN, FMR. FDA COMMISSIONER: I can just tell you from FDA perspective, yes, we felt pressure. I can tell you that no one called me on the phone and said, I want a vaccine approved before election day.

GUPTA: The President never said?

HAHN: President never said that to me. Get it out as quickly as possible. Yes, to save lives. That was the conversation. But of course, everyone heard what was being said publicly.

TRUMP: We have the best medicines in the world. And the vaccines are coming momentarily.

GUPTA: What we did hear from the President was that he believed there was politics at play with regard to when the data was released, that it could have been released earlier, that it was done to hurt his reelection chances.

HAHN: I can categorically tell you, from my point of view, as FDA Commissioner, that we did not play politics with respect to the timing and the release of the data.

UNIDENTIFIED MALE: Mr. President, the FDA is reportedly considering stricter guidelines for the emergency authorization of a COVID vaccine.

TRUMP: That sounds like a political move.

GUPTA: It strikes me, Dr. Hahn, the idea that that job is FDA Commissioner, which is so predicated on science and evidence data should also be a politically appointed job. In the spirit of this autopsy, are there lessons in there going forward? Should the FDA Commissioner be a politically appointed position?

HAHN: Having a set term, potentially that's outside of the political schedule, if you will, I think there's some real benefits to consideration of that.

REDFIELD: I personally have felt and I will, as a former CDC director, share my opinion to those who will listen, that this job should be so seven to 10 year appointment. I feel the same way about NIH and the FDA. I think these are important jobs to get out of the political cycle for sure.

[22:50:11]

GUPTA (voice-over): CDC, FDA, NIH, these aren't just important jobs. They represent our country's most trusted scientific institutions. And over the past year that trust has sadly eroded, a legacy of this pandemic that many worry will outlast all of the doctors who tried to lead us through it.

DR. BRETT GIROIR, FMR. ASSISTANT SECRETARY FOR HEALTH, HHS: Whether right or wrong history will tell I know we gave it everything we did we were honest with the American people and i do believe that all of us want the Biden administration to be enormously successful and to do things that we never did.

GUPTA (on camera): Is this an emotional time for you?

GIROIR: Yes it's an emotional time. I felt the lives of everybody's grandmother on my shoulders. BIRX: It's not just the depth of the loss of the fatalities, it is the crippling anxiety and fear that people have lived with is their loved one going to survive, are they going to see them again and when you see how other countries that are similar to us were able to get their children into school. You can't look at any of this and say it was OK.

GUPTA: The best we could do seemingly if you look at the data was be the worst in the world in terms of overall number of cases. What did we miss?

GIROIR: We have a terrific sick care system. We don't have a public health or welfare system and that's really the fundamental paradox.

REDFIELD: The reason the mortality rate is greater in America than it is in these other countries is not because our doctors don't know how to take care of these patients. The reason is unfortunately the American public is less healthy. A third of us can meet the criteria for being defined as obese. You don't find that in South Korea.

UNIDENTIFIED MALE: We saw it by the degree of comorbidities and our population.

BIRX: 96 percent of the individuals who died from COVID had these co- morbidities.

GUPTA: People may still say look i don't want to be the guy that authorized billions of dollars in spending every year for a threat that never happened. Yes, pandemic may come again but maybe not for 100 years.

DR. ROBERT KADLEC, FMR. ASST. SECRETRY FOR PREPAREDNESS AND RESPONSE, HHS: And here's my answer to that we have seen what the cost of unpreparedness has been, right. We have 11 aircraft carriers. We invest in those at about $17 billion a pop to build. We're talking about one aircraft carrier investment to make America not only safer but healthy.

FAUCI: I would hope that as a nation we'd realize that we can't do it this way again. This is a war. So if you're going to fight a war you better start shooting at the enemy instead of at each other.

GUPTA: Maybe you and I be having this conversation again. I hope we're not over a pandemic but if we already think things will be different?

FAUCI: I can't guarantee it but i hope so. I'm nervous about the intensity of the divisiveness in the country right.

JOE BIDEN, PRESIDENT OF THE UNITED STATES: Hey, doctor, how are you?

FAUCI: President Biden is doing a lot of things to really get science back on track so I'm looking forward to the next four years.

The idea that you can get up here and talk about what you know, what the evidence, what the sciences and now --

GUPTA (voice-over): After speaking with the doctors just days after the new administration took over --

FAUCI: It is somewhat of a liberating feeling.

GUPTA: It occurred to me that only Dr. Fauci will be able to continue his work and see this fight through until the end, something that was not lost on Dr. Birx either.

BIRX: I try not to think about this from a personal perspective because it's devastating to think about it from a personal perspective of what people are saying and how people have interpreted your actions but it's important for America at this moment for them to have a clean break.

Thank you, Mr. President.

GUPTA (on camera): Dr. Fauci in many ways has earned the reputation as sort of America's doctor through all this and a lot of times people refer to you by your scarves why do you think that is?

BIRX: I saw it every place I went. I mean obviously I came up in a very difficult time very few women in madison, almost no women in the military, that's the world that I have been in my entire life. We're just held to a very different standard and I think we have to be very careful that a lot of these perceptions still continue.

GUPTA: At the end of the postmortem, you have to write down the primary cause of death. What would you write when it comes to this pandemic?

[22:55:06]

BIRX: Not being as prepared as we thought we were. And not implementing what we knew worked.

GIRIOR: I would probably write in the top line is a lack of transparency early on from China as the cause of death.

REDFIELD: I would say that we lacked the public health infrastructure that could confront the pandemic at the time we hadn't used one.

FAUCI: I think it's the environment in which the outbreak occurred in our country.

HAHN: We are so divided. And there's a lot of mistrust across the board in the U.S. and we need to overcome that, we need to come together.

KADLEC: For me, one of the big ones was hubris. And it transcends, I think institutions that transcends personalities. It was this idea that somehow we could just weather our way through this.

GUPTA: What's the therapeutic for hubris/

KADLEC: All I think what we've experienced too hard lesson, hard series of lessons. That's the opportunity in the midst of this challenge. What -- Where do we go from here? As bad as this was, it could be worse. And there will be another pandemic. Guaranteed.

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