(CNN)  No longer working under the T-RUMP administration, six leading US health officials now reveal to CNN the real challenges they faced during the nation's fight against Covid-19 over the past year: death threats, mixed messages and in some cases, being kept from sharing information with national audiences.

The nation's doctors -- Dr. Deborah Birx, Dr. Anthony Fauci, Dr. Brett Giroir, Dr. Stephen Hahn, Dr. Robert Kadlec and Dr. Robert Redfield -- were fighting a pandemic that would claim more than 500,000 American lives, all while navigating a White House fraught with strained relationships and very little mask-wearing.

The six doctors responsible for the previous administration's Covid-19 response reflect on the past year with CNN's Chief Medical Correspondent Dr. Sanjay Gupta in a new CNN special report, “COVID WAR: The Pandemic Doctors Speak Out."

Their reflections reveal a common theme — there was contention behind closed doors and a lack of preparedness.  Just as there has been growing divisiveness in the United States during the pandemic, there was divisiveness among America’s leadership.

I Could See The Avalanche Coming  —  
From the beginning, the doctors serving the White House could see the public health threat ahead of them -- but there were some Trump administration officials who "believed this wasn't as a big of deal" as the doctors were making it seem, Dr. Deborah Birx, the White House's coronavirus response coordinator under President Trump, told Gupta.

When Birx, a physician and public health expert, was tapped to join the White House’s coronavirus task force in late February, she had an initial goal.  "First, I wanted to make sure that we stopped saying that the risk to Americans was low," Birx said. "I could see the avalanche coming, and I could see that we were not prepared, and I thought I could do something."

But in the White House, "there was a group that really believed this wasn't as a big of deal as we were making it," she said. "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."

This division could be seen in some of the White House coronavirus task force's public briefings, especially when it came to wearing masks. Sometimes the doctors were the only officials -- or among the very few -- seen with masks on.

"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 mask-wearing in the White House," Birx told Gupta.

"There was one event in the Rose Garden, it was made clear that they didn't want us wearing masks," she said. "So all of the Cabinet officials and even some of the military members took their masks off. Dr. Fauci and I did not.”

Trump’s ‘Parallel Streams Of Data  —  As the pandemic progressed, there were "too many parallel streams of data" about the pandemic being presented Trump, Birx said, also stressing that concern about the US economy seemed to outweigh concern about hospitalizations and deaths. 

"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," Birx told Gupta.

"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 happened again, because there were too many parallel streams of data," Birx said. 

"These parallel data streams, you think they originated with Scott Atlas?" Gupta asked. Atlas, a neuroradiologist, was a highly controversial adviser to Trump on the coronavirus pandemic. Atlas resigned from the T-RUMP administration in November.   "I know some of them came from his team," Birx said. "I don't know where all of them came from." 

CNN reached out to Atlas for comment.  Dr. Birx vows she won’t sit with T-RUMP-picked task force member Atlas.   

But some of the misleading information coming from Atlas was enough for Birx to refuse to attend meetings with him.

"I told people I would not be in a meeting with Dr. Atlas again," she said. "I felt very strongly that I didn't want an action that legitimized in any way his position."

That position -- one that several experts have disputed -- was in support of allowing the virus to spread in healthy populations in order to develop natural herd immunity. Such an approach would mean that many people nationwide would have to get sick with the coronavirus in order to build up immunity across communities. As the virus spreads and sickens people, many could die in the process.

“Day one when he showed up that was very clear it was written as his view," Admiral Brett Giroir, who served as US Health and Human Services assistant secretary under the former President, told Gupta.  "The subtlety here though is he thought you can protect the vulnerable and let sort of the well build up this herd immunity," Giroir said. "Dr. Birx and I and the rest of the docs said, ‘This is a fallacy.' “   The pandemic "was a community spreading event and there was no way to ring-fence vulnerable Americans," Birx said. 

It Was Reported ... We Had A Shouting Match  —  At the same time there was some tension between the doctors and Atlas, there apparently was contention between former Health and Human Services Secretary Alex Azar and the former heads of the nation's top public health agencies: the US Food and Drug Administration and the US Centers for Disease Control and Prevention.

"It was reported in the press that we had a shouting match," Dr. Stephen Hahn, former FDA commissioner, told Gupta. “  can 100% assure you that I did not shout and scream at the secretary of Health and Human Services."   "Did he shout out at you?" Gupta asked.   
“You should ask him that question," Hahn replied.  HHS Secretary Alex Azar complains of tarnished legacy in resignation letter to T-RUMP,  Azar responded in a statement to CNN that "FDA's illegal assertion of jurisdiction over common lab developed tests ... slowed the development of U.S. COVID testing ... Dr. Hahn's recitation of this call is incorrect ... the only intemperate conduct... was Dr. Hahn's threat to resign."

In a response to Azar’s statement, Hahn said: "I did not yell on that phone call, and I did not threaten to resign."   Former CDC Director Dr. Robert Redfield also told Gupta that his relationship with Azar was challenging. 

"I didn't have really very difficult challenges with the White House. The challenges I had were with the office of the Secretary," Redfield said. "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."

The CDC's Morbidity and Mortality Weekly Report, or MMWR is the agency's published roundup of key research on death and disease as well as recommendations. The CDC website notes that the MMWR is often called “the voice of CDC." Redfield said that he was asked to change the report "on more than one occasion."

Azar responded in a statement to CNN saying, in part, "Any suggestion that I pressured or otherwise asked Dr. Redfield to change the content of a single scientific, peer-reviewed MMWR article is false.

I got called by the President  —  The pandemic quickly became politicized in the United States.  Birx said that she faced "difficult" consequences for speaking publicly about the threat of the pandemic and its widespread reach to rural communities.

In August, Birx appeared on CNN's "State of the Union"and warned about the coronavirus being "extraordinarily widespread" across both rural and urban communities.   Birx then received what she describes as a "very uncomfortable" and "very difficult" phone call from the former President.

"It was a CNN report in August that got horrible pushback. 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," Birx told Gupta.

"I got called by the President," she said. “It was very uncomfortable, very direct and very difficult to hear."  Gupta asked, “Were you threatened?"  Birx responded, "I would say it was a very uncomfortable conversation."

After that, Birx started to give public warnings about the pandemic on a local level because “someone was blocking" her from speaking nationally, she said.  Were you being censored?" Gupta asked.

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

A Pandemic Plagued With Mixed Messages  —  The nation’s doctors were not blind to the mixed messages that the American public has seen during the pandemic -- with some officials claiming the spread of disease was not as bad while others stressed it was much worse.  This was also seen with messaging around masks.

Some public health bodies first asked people not to wear masks because there was concern about supply and not having enough for frontline workers. Then, as the world learned more about how easily the coronavirus was being transmitted, there was a sudden flip to urge everyone to mask up. Now research suggests wearing two masks, or double masking, is even better.

There also was the message from the doctors for people to stay home and for states to shut down. At the same time, the former President called for states to open. That message shocked Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. 

Fauci, now President Joe Biden's chief medical adviser and the only one of the doctors still working in the White House, described Trump's message as "a punch to the chest."

"I said to myself, 'Oh my goodness, what is going on here?' It shocked me because it was such a jolt to what we were trying to do,” Fauci told Gupta.  As the pandemic went on, public briefings held by the White House's coronavirus task force became infrequent. 

Coronavirus task force members were sometimes kept out of public view. The task force itself, which once convened daily, was relegated to meeting once or twice a week -- and engaged with the former President less often.

But when the White House coronavirus task force meetings became irregular, behind the scenes, four of the doctors -- Birx, Fauci, Hahn and Redfield -- started their own "doctors' group," as Fauci called it.   "We weren't secret about it. We were pretty open about it. It's just that not very many people knew about it," Fauci told Gupta.

Birx described the group as “ mportant," because her colleagues were attending House and Senate briefings about the pandemic -- and she wanted them armed with the latest data she had available to share with lawmakers.

I Could Use The Word “Cover Up  —  "I think we could have learned very quickly that we're dealing with a different beast than the one that everyone had sold us," Redfield said.   He told Gupta that Trump called China's President Xi Jinping, and Azar made requests to China's minister of health -- but none of the outreach helped.

Redfield said that he believes the origin of the coronavirus pandemic was a lab in China -- a controversial theory without evidence. He added he didn’t think it was intentional.  “I still think the most likely aetiology of this pathogen in 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," Redfield told Gupta. 

"A year after this pathogen started, we're now having a critical analysis of where it came from by scientists," Redfield said. "It seems to me that some of the information is people are not being transparent about it. I could use the word ‘ over up,' but I don't know that so I'm not going to speculate that."  China has denied any cover up. 

The Wuhan Files  —  
Gupta asked Fauci, “ ow big of a difference would it have been if our own investigators had been on the ground in China?"  Fauci said that it would have made a “ ignificant" difference -- and he was "always" skeptical about the Covid-19 data being reported out of China.  "I always had skepticism about it because of what we went through with SARS," Fauci said.

"China was saying, 'Oh it's flu, it's flu,' and then the next thing you know, SARS was all over the world -- in Canada, in Australia, all over the place," he said. "They were not very transparent in the past. It wasn't outright lying. They just didn’t give you all the information."  The doctors also agreed that it would have made a difference if the United States was better prepared for what was to come.

We had no systems in place  —  The United States did not know how much emergency supply of personal protective gear, medicines, ventilators and other medical equipment the nation had access to at the start of the pandemic, Dr. Robert Kadlec, former US assistant secretary of Health and Human Services, told Gupta.

Early in the pandemic, complaints about dire shortages of protective gear for medical workers on the frontlines of the Covid-19 crisis began to stream in. Trump was quick to point the finger of blame at his predecessor, President Barack Obama.

It was Obama and other administrations, he said, who left the shelves of the nation's Strategic National Stockpile bare of the items needed to combat the coronavirus. To an extent, the former President was right. The Obama administration did use and then failed to replace items from the stockpile to fight the 2009 H1N1 "swine flu" pandemic. But Trump hadn't replaced those items either, despite repeated warnings that the country was ill-prepared for a pandemic, stockpile experts said.

The President's criticism also ignored a key point: The stockpile was never intended -- or funded -- to be a panacea for a pandemic. Rather, it serves as one piece of the overall supply chain puzzle during a disaster.  "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," Kadlec told Gupta.

Months later, Kadlec found himself included in a whistleblower complaint that alleges he and others within the US Department of Health and Human Services responded slowly to the coronavirus outbreak. Kadlec told Gupta that he would "challenge some of the accuracies" of that complaint. 

Overall, “we had no systems in place," Giroir told Gupta.   "What's the supply chain? We don't know," Giroir said. "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.”  The doctors now hope that the nation is better equipped and more united in its fight against Covid-19.

All The Doctors Received Death Threats  —  More than a year after the COVID-19 pandemic was declared, there is still divisiveness across the United States, Fauci told Gupta.   "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," Fauci said. "I'm nervous about the intensity of the divisiveness in the country right now."

The division became so intense early in the pandemic that by April of last year, Fauci required personal security from law enforcement at all times — including at his home -- due to threats to his safety.  "All the doctors received death threats," Birx told Gupta.

"My daughters got the same rude text messages," she said. "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.'"

Birx said that she originally would take the threats to the State Department, but eventually “didn't have time."  Former FDA Commissioner Hahn also shared concern about divisiveness in the country.  "We are so divided and there's a lot of mistrust across the board in the US," Hahn told Gupta. "We need to overcome that. We need to come together."

Finally The Answer To Where Is Deborah Birx?

The US may finally be getting a handle on the COVID-19 pandemic, but for so many Americans, it’s too late, and that disconnect is raising fresh questions about why the US couldn’t have done more earlier. 

Dr. Deborah Birx, who served as the White House coronavirus response coordinator under the Trump administration, reveals her chilling conclusion in a new CNN documentary that the number of coronavirus deaths could have been "decreased substantially" if cities and states across the country had aggressively applied the lessons of the first surge toward mitigation last spring, potentially preventing the surges that followed. 

It is a bracing retrospective from one of the top doctors who was tasked with halting the pandemic, and it comes at a time when many grieving families are still trying to understand how one of the wealthiest and most powerful nations in the world was unable to prevent the loss of nearly 550,000 lives. 

CNN Chief Medical Correspondent Dr. Sanjay Gupta asked six of the doctors who ran point on the pandemic response, including Birx, to provide their insights on what the US could have done differently in the new documentary, "COVID WAR: The Pandemic Doctors Speak Out," which airs Sunday at 9 p.m. ET on CNN. The doctors all painfully dissected the country's missteps that led to the enormous loss of life. But Birx saw it most starkly, stating that the vast majority of America's deaths could have been prevented, a painful interpretation of the last year for a nation still trying to come to terms with the ongoing loss of life. 

In recent weeks, the news has been dominated by positive signs, like the rapidly accelerating pace of vaccinations and the fact that 71% of Americans 65 and older already having received one shot. The nation seems to be breathing a collective sigh of relief that the United States is no longer staggering through the frantic triage mode that characterized most of the last year, even if the data isn't all trending in the right direction.

While Dr. Anthony Fauci and Dr. Rochelle Walensky, President Joe Biden's pick to lead the US Centers for Disease Control and Prevention, keep urging Americans to mask up and not to let their guards down -- especially given the rise in new variants -- the nation has arrived at a calmer moment of introspection, one where there is time to actually reflect on what went wrong.

One area that is drawing new scrutiny is how long it took for former President Donald Trump and his Covid-19 advisers to declare a pause to slow the spread in March 2020 after the initial surge in coronavirus cases began -- and how many lives could have been saved if all Americans had really adhered to the restrictions on gatherings and social distancing. In the new documentary, Birx gives Gupta her gut-wrenching answer when asked how much of an impact it would have made if the US had paused earlier and followed through with the safety measures that were proven to slow the spread.

"I look at it this way. The first time we have an excuse," Birx says. "There were about a hundred thousand deaths that came from that original surge. All of the rest of them, in my mind, could have been mitigated or decreased substantially."

A key study from Columbia University released last year underscored the devastating conclusion that earlier intervention could have saved tens of thousands of lives. Researchers at Columbia built a model to examine transmission rates between March 15 and May 3, 2020 -- and they determined that if the country had shut down two weeks earlier, it could have prevented 84% of deaths at the time. 

As the US inches toward normalcy, the best outcome of this moment of reflection is that Americans will continue to take the virus seriously, embracing the role that they can each continue to play in preventing more deaths by wearing masks, avoiding large gatherings and showing up to get vaccinated when it is their turn. There are alarming signs that some people are moving on to the next phase too soon, even though the risks are still high: Miami Beach has struggled to get control of a flood of spring breakers who crowded its streets and air travel is upfrom a year ago for the first time since the pandemic began.

Walensky noted Friday that case numbers are headed in the wrong direction, increasing 7% over the previous seven-day period, and she pointed out that the average number of deaths is still hovering around 1,000 a day. Hospitalizations also increased slightly this week compared with the previous seven-day period.

"I remain deeply concerned about this trajectory. We have seen cases and hospital admissions move from historic declines to stagnations to increases," Walensky said during the White House Covid-19 task force briefing Friday. "And we know from prior surges that if we don't control things now, there is a real potential for the epidemic curve to soar again. Please, take this moment very seriously.”

“All The Doctors” Working On COVID-19 Response Received Death Threats --

Dr. Deborah Birx, who served as the White House COVID-19 response coordinator under former President Trump, reveals in a CNN special report that "all the doctors" on the White House coronavirus task force have received death threats.   Reports emerged early in the pandemic that Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, was forced to beef up security due to an increase in death threats.

"All the doctors received death threats," Birx told Dr. Sanjay Gupta in the documentary "COVID WAR: The Pandemic Doctors Speak Out."

"My daughters got the same rude text messages. I mean, you can't even imagine what those text messages looked like," Birx said. "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.' “  Birx said she originally took the threats to the US Department of State, but eventually she “ Didn’t have time".

Controversy Over The Origins Of The Virus  —  
As the doctors who served in the Trump administration begin to talk more openly about the nation's missteps, one key piece of the puzzle is understanding the origins of the pandemic -- and what could have been done in those early months to halt the spread of Covid-19, which had reached US shores by January 21, 2020.

In another excerpt of the CNN documentary released Friday, Dr. Robert Redfield, the former director of the CDC, expressed fresh skepticism about China's explanation that the initial Covid-19 cases emerged in a wet market in Wuhan. He told Gupta that he is convinced the pandemic began several months before the US was notified of the "mysterious cluster of pneumonia patients" in late December -- raising the specter that the US and the world lost a precious period when they could have begun preparing for the outbreak to mitigate deaths.

Without citing any evidence to back up his claim, Redfield also told Gupta he believes the pandemic originated in a lab in China that was already studying the virus, a controversial theory that the World Health Organization called "extremely unlikely" and for which there is no clear evidence.

"If I was to guess, this virus started transmitting somewhere in September, October in Wuhan," Redfield told Gupta in a clip from the documentary. "That's my own feelings. And only opinion. I'm allowed to have opinions now."

On Friday, White House press secretary Jen Psaki said the Biden administration was reserving judgment on that question until the World Health Organization releases its final report on the origins of Covid-19. Peter Ben Embarek, who headed the organization's Covid-19 origin investigation, told reporters during a separate briefing on Friday that the report is now complete and will be released to the public within a few days. Investigators visited the lab at the center of the controversy and Embarek told CNN in February that the team had determined the virus was much more widespread in Wuhan than originally thought back in December of 2019.

Fauci, the nation's top infectious disease expert, seemed to downplay the possibility that Redfield's explanation is correct during the White House Covid-19 briefing on Friday.

"Obviously, there are a number of theories," said Fauci, director of the National Institute of Allergy and Infectious Diseases. "Dr. Redfield was mentioning that he was giving an opinion as to a possibility, but again, there are other alternatives — others, that most people hold by." 

A Push Toward 200 Million Shots In 100 Days  —  
While the US waits for those conclusions, the Biden administration announced new steps on Friday to meet the President's new goal of 200 million shots by his 100th day in office. Jeff Zients, the White House Covid-19 response coordinator, said maintaining the current pace of 2.5 million vaccinations per day for the next five weeks will be the equivalent of vaccinating a sellout crowd at Yankee Stadium 50 times a day.

About 49 million Americans are now fully vaccinated, and about 1 in 3 have received at least one dose. But White House officials are highlighting the fact that 71% of seniors have received one shot, because that age group accounts for roughly 80% of the Covid deaths up to this point.

With the increase in vaccine supply, Zients affirmed Friday there will be enough vaccine doses for every adult in the US by the end of May and said the three manufacturers who have received emergency use authorization for their vaccines in the US -- Pfizer, Moderna and Johnson & Johnson -- "are setting and hitting targets."

While increasing the number of available doses at pharmacies and community vaccination sites, the administration announced three new federally run mass vaccination sites on Friday in Boston, Norfolk, Virginia, and Newark, New Jersey. At the President's urging, Zients also noted that most states and the District of Columbia have now outlined their plans to make all Americans eligible for the vaccine by May 1.

"It's clear there is a case for optimism, but there is not a case for relaxation," Zients said. "This is not the time to let down our guard."

3/27/2021   aljacobsladder.com