WASHINGTON — Top White House officials pressured the Centers for Disease Control and Prevention this summer to play down the risk of sending children back to school, a strikingly political intervention in one of the most sensitive public health debates of the pandemic, according to documents and interviews with current and former government officials.
As part of their behind-the-scenes effort, White House officials also tried to circumvent the CDC in a search for alternate data showing that the pandemic was weakening and posed little danger to children.
The documents and interviews show how the White House spent weeks trying to press public health professionals to fall in line with President Donald Trump’s election-year agenda of pushing to reopen schools and the economy as quickly as possible. The president and his team have remained defiant in their demand for schools to get back to normal, even as coronavirus cases have once again ticked up, in some cases linked to school and college reopenings.
The effort included Dr. Deborah Birx, the White House’s coronavirus response coordinator, and officials working for Vice President Mike Pence, who led the task force. It left officials at the CDC, long considered the world’s premier public health agency, alarmed at the degree of pressure from the White House.
One member of Pence’s staff said she was repeatedly asked by Marc Short, the vice president’s chief of staff, to get the CDC to produce more reports and charts showing a decline in coronavirus cases among young people.
The staff member, Olivia Troye, one of Pence’s top aides on the task force, said she regretted being “complicit” in the effort. But she said she tried as much as possible to shield the CDC from the White House pressure, which she saw as driven by the president’s determination to have schools open by the time voters cast ballots.
“You’re impacting people’s lives for whatever political agenda. You’re exchanging votes for lives, and I have a serious problem with that,” said Troye, who left the White House in August and has begun speaking out publicly against Trump.
According to Troye, Short dispatched other members of the vice president’s staff to circumvent the CDC in search of data he thought might better support the White House’s position.
“I was appalled when I found out that Marc Short was tasking more junior staff in the office of the vice president to develop charts” for White House briefings, she said.
After Troye went public this month, Short told MSNBC that she had a vendetta against the president and that she left the White House because “the strain was too much for her to do the job.”
Several former officials said that before one task force briefing in late June, White House officials, including Troye, spoke to top CDC officers asking for data that could show the low risk of infection and death for school-age children — “a snazzy, easy-to-read document,” one former senior public health official recalled.
The White House seized on a bar chart the CDC distributed that week to other agencies, which showed that 60% of coronavirus deaths were people over the age of 75. Officials asked the CDC to provide a new chart to show people 18 and under as a separate group — rather than including them as normal in an under-25 category — in an effort to demonstrate that the risk for school-age children was relatively low.
In another instance, Birx took a direct role in an effort to push the CDC to incorporate work from a little-known agency inside the Department of Health and Human Services, the Substance Abuse and Mental Health Services Administration.
The document worked on by the mental health agency struck a different tone from the cautious approach being proposed by the CDC, warning that school closures would have a long-term effect on the mental health of children. It said that “very few reports of children being the primary source of COVID-19 transmission among family members have emerged” and asserted that children who were asymptomatic “are unlikely to spread the virus.”
In a July 19 email, Birx asked Dr. Robert Redfield, the CDC director, to incorporate the document “as background in the introduction section” of the CDC guidance.
CDC scientists pointed out numerous errors in the document and raised concerns that it appeared to minimize the risk of the coronavirus to school-age children, according to an edited version of the document obtained by The New York Times. The CDC was successful in beating back some of the proposed changes, and the line about asymptomatic children was not included in its final guidelines.
But the gist of the mental health agency’s position — stressing the potential risks of children not attending school — became the introductory text of the final CDC policy, leaving some officials there dismayed.
Brian Morgenstern, a White House spokesman, said the coronavirus task force brought together public health officials “who offer different expertise and views on a variety of issues” in setting policy.
“President Trump relies on the advice of all of his top health officials who agree that it is in the public health interest to safely reopen schools, and that the relative risks posed by the virus to young people are outweighed by the risks of keeping children out of school indefinitely,” Morgenstern said.
The CDC did not immediately provide a comment.
The internal battle began in July, weeks after a group of CDC career employees began drafting what would become the agency’s guidance to assist parents in making decisions about whether to send their children back to school. Trump had publicly made his preference clear. “We want to get them open quickly, beautifully, in the fall,” he said, adding that “young people do extraordinarily well” in avoiding the disease.
One of the guidance documents the CDC produced was a “decision-making tool” urging parents to “consider the full spectrum of risks involved in both in-person and virtual learning options,” according to a draft reviewed by The Times that reflected the language later published by the CDC.
The seven-page draft conceded that scientists were “still learning about how it spreads, how it affects children and what role children may play in its spread,” and that limited data suggested that children were less likely to get the virus than adults.
At the same time, it warned of deaths caused by multisystem inflammatory syndrome and of some children being at increased risk of severe illness. It recommended that parents consider whether others in a household might be at increased risk.
In early July, Trump became angry about what he thought were the CDC’s overly stringent recommendations. “The Dems think it would be bad for them politically if U.S. schools open before the November Election, but it is important for the children and families,” he said on Twitter. “May cut off funding if not open!”
Hospitalizations of children over the summer remained relatively low, and some outside organizations were also advocating for schools to open, as long it could be done safely. The American Academy of Pediatrics issued a statement that policymakers “should start with a goal of having students physically present in school,” though it warned that areas with high infection rates would not be able to open safely.
More recently, data compiled by the academy from recent months shows that hospitalizations and deaths from the coronavirus have increased at a faster rate in children and teenagers than among the general public.
A large study from South Korea published in July showed that children between the ages of 10 and 19 can spread the virus at least as much as adults do. More data from researchers called into question who was infecting whom.
The perils for school districts that have tried to reopen have become clearer this fall. At least one coronavirus case had been reported in more than 100 school buildings and early childhood centers in the New York City school system by the first day of limited in-person instruction last week.
In the weeks after Trump’s public statements, the administration was working to counter the CDC’s cautious position.
The White House drafted materials that CDC officials originally believed were intended to be posted on the White House website, including an illustrated slide presentation emphasizing the “high costs of keeping schools closed,” while asserting that school-age children face minimal risks from the coronavirus.
The CDC raised objections to the presentation, and it was never published.
In mid-July, after the CDC had distributed its proposed guidance to the White House and other health agencies, the agency received a formal rejection of its work: a “non-concur” decision by the Substance Abuse and Mental Health Services Administration, the agency that White House officials saw as a counterweight to the CDC’s position.
Officials at the mental health agency told the CDC that there was “too much information” in the guidance, and that information was “presented in a negative way,” according to an email distributed to CDC officials.
“Our message on this is that this is a recipe for schools to stay closed,” the agency wrote.
The agency had helped prepare a five-page document supportive of reopening schools, the document that Birx sent to Redfield on July 19. It described children as being at low risk for being infected by or transmitting the virus, even though the science was far from settled.
By then, the position by the mental health agency had been embraced by top White House officials.
“It was seen as an argument to open up the country by getting kids back in schools,” Troye said.
Troye said she tried to blunt the political offensive against the CDC scientists the best she could.
“It was hard to walk away from that,” she said, “knowing that it was going to get even harder for them after I left.”
After the CDC scientists successfully managed to get some material they considered objectionable out of the document, the White House’s Office of Management and Budget cleared the CDC’s guidance.
But then the White House abruptly reversed course, telling the CDC that it wanted to add, as a preamble to the guidance, language that the mental health agency had worked on listing the benefits of sending children back to school. That document, with some CDC edits, was given a new title: “The Importance of Reopening America’s Schools This Fall.”
On July 23, with hours to go before the new guidance was to be published, the White House staff secretary further stunned CDC officials by emailing the guidance to top White House officials, asking for any “critical edits” by 1 p.m. The list included Mark Meadows, the chief of staff; Jared Kushner, the president’s son-in-law and senior adviser; Larry Kudlow, the director of the National Economic Council; and Stephen Miller, a White House policy adviser.
By the time it was published, it contained information that CDC officials had objected to earlier in the week, suggesting in particular that the coronavirus was less deadly to children than the seasonal flu.