A Plague Upon Our House: My Fight at the Trump White House to Stop COVID from Destroying America, by Scott W. Atlas (Bombardier Books, 328 pp., $28)
How could public officials vowing to “follow the science” on Covid-19 persist in promoting ineffective strategies with terrible consequences? In a memoir of his time on the White House Coronavirus Task Force, Scott W. Atlas provides an answer: because the nation’s governance was hijacked by three bureaucrats with scant interest in scientific research or debate—and no concern for the calamitous effects of their edicts.
Atlas’s book, A Plague Upon Our House, is an astonishing read, even for those who have been closely following this disaster. A veteran medical researcher and health-policy analyst at the Hoover Institution, Atlas, a radiologist, joined the Task Force six months into the pandemic, after he had published estimates that lockdowns could ultimately prove more deadly than Covid.
Atlas expected to spend his time at the White House discussing scientific data and debating the best strategies for protecting public health. Instead, he found that the Task Force included “zero public health policy experts and no experts with medical knowledge who also analyzed economic, social, and other broad public health impacts other than the infection itself.” Vice President Mike Pence chaired the Task Force, but Atlas says that Pence and the other members were regularly cowed into submission by three doctors who dominated from the start: Deborah Birx, the Task Force’s coordinator, along with Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, and Robert Redfield, director of the Centers for Disease Control.
Atlas calls them “the troika” because of their strategy for presenting a united front, never disagreeing with one another during the meetings in the White House Situation Room. (Reporting later revealed that they had made a pact to resign in unison if any of them was fired.) These veterans of the federal bureaucracy had worked closely together during the AIDS epidemic, and their track record was hardly reassuring. Their long and costly quest to develop an AIDS vaccine ultimately failed, but they did manage to persuade the public that AIDS would spread widely beyond gay men and intravenous drug users. Redfield, with some help from Fauci, was the chief prophet of a “heterosexual breakout,” a threat that terrified Americans for more than a decade but never materialized.
The troika stoked more needless fears during the Covid pandemic, continually emphasizing worst-case scenarios—the computer models, for example, that wrongly forecast millions of American deaths in the summer of 2020. Surveys showed that most Americans, especially young people, vastly overestimated their risk of serious disease. Yet Fauci still wasn’t satisfied, as Atlas discovered when Fauci complained during one meeting that Americans didn’t take the virus seriously. “I challenged him to clarify his point,” Atlas writes, “because I couldn’t believe my ears. ‘So you think people aren’t frightened enough?’ He said, ‘Yes, they need to be more afraid.’ To me, this was another moment of Kafkaesque absurdity. . . . Instilling fear in the public is absolutely counter to what a leader in public health should do. To me, it is frankly immoral, although I kept that to myself.”
Fauci got the most media attention of the troika, but Atlas thinks that Birx did the most damage. As Pence’s chief subordinate on the Task Force, she shaped its agenda, participated in the regular “Covid huddle” with White House officials, and traveled the country, successfully pressuring state and local leaders to issue mask mandates and close businesses and schools. In one of Atlas’s first meetings with her, he asked her what she considered the strongest scientific evidence for the efficacy of masks against Covid. She cited a report published by the Centers for Disease Control about a hair salon in Missouri, where two stylists infected with Covid had worn masks that supposedly prevented the virus from infecting their customers.
“I knew the study well,” Atlas writes, “having already dissected it in detail with a few epidemiologists before I set foot in Washington. My colleagues had all laughed at it. It was poorly done, and the conclusions were not valid. It was an embarrassment that it had been published prominently on the CDC website.” Among the many limitations of this small study, critics had noted that, while none of the customers contacted by the researchers reported Covid symptoms, most of them were never tested for the virus, and many of the stylists’ customers were never contacted at all.
Atlas tells how he tried, “in as diplomatic a way as I could muster,” to discuss these limitations with Birx, but she bristled. He soon realized that she wasn’t even familiar with the basic aspects of the study she was using to justify mask mandates across the U.S. Nor did she or the rest of the troika show interest in the many far more rigorous studies with contrary findings. Though Redfield would later concede, after leaving the CDC, that there was a “paucity of data” to justify mask mandates, during the Task Force meetings the troika refused to debate any scientific research challenging their mask mandates and lockdowns, according to Atlas. “Unlike scientists with whom I had worked for decades,” he writes, “I never saw them voice any critical assessment, methodological or otherwise, of the pitfalls of any published studies.” Atlas says that they never brought scientific papers to the meetings and declined to respond to his presentations about the research.
“For what I anticipated would be a data-ﬁlled discussion about opening schools and the risk to children,” Atlas says, “I brought approximately ﬁfteen different studies and a summary sheet of the research. For what I hoped would be a discussion about testing guidance, I brought and distributed articles and other documents about the role and pitfalls of PCR testing and concerns about cycle thresholds. Even though I handed out a number of these published studies to everyone at the table, no one ever mentioned them in the Situation Room. My guess was that no one in the Fauci-Redﬁeld-Birx troika ever opened them.”
Instead, the troika of bureaucrats obsessed over Birx’s charts showing how many Covid tests had been administered and what percentage were positive. They proclaimed success for their strategies when infections started to wane in states like New York and Arizona—never mind that the downward trends began before the lockdowns and mask mandates were imposed. They ignored inconvenient data, like the chart that Atlas reproduces comparing the rates of Covid cases in states with and without mask mandates: the two curves remained virtually identical throughout the pandemic. “The doctors in the Task Force showed no study about mask efficacy or any other of their policies, and they never once mentioned the harms of the lockdowns that I witnessed,” Atlas says. “Their sole focus was stopping cases, even when their policies were already implemented and were failing to do so.”
Atlas’s book is obviously a one-sided account and at times lapses into self-righteousness. But his portrayal of the troika—a better term might be the three blind mice—rings true, both because of the details he provides and because it jibes with what he and they were saying (and not saying) publicly throughout the pandemic. It may seem incredible that the troika would violate a fundamental principle of public health by ignoring the devasting collateral damage of their policies, yet they never even pretended to conduct a cost-benefit analysis. “Perhaps the most remarkable insight in the Fauci email trove,” Atlas notes, referring to the thousands of emails from Fauci that were made public, is “the total lack of mention of harms from the lockdown throughout the pandemic.”
The troika also ignored dozens of studies showing the ineffectiveness of lockdowns, and the data showing that places that avoided lockdowns, like Florida and Sweden, did as well as or better than average in preventing Covid deaths. “I never fully understood why there was no admission, even internally by the Task Force, that the Birx-Fauci strategy did not work,” Atlas writes, concluding that it wasn’t simply because the media was eager to champion anyone who questioned President Donald Trump’s desire to reopen schools and businesses. “Disagreeing with Trump, especially in this election year, ensured near idolatry on cable TV and in the New York Times or Washington Post. But I never thought politics was the main driver of those on the Task Force. Perhaps it was an unstated fear that they were in way too deep to admit their errors.”
Mainstream media were the chief weapon the troika wielded against Atlas and scientists who opposed lockdowns and instead advocated a policy of “focused protection” that would concentrate testing and related resources on the elderly or other high-risk populations. (Atlas invited Birx to a meeting in the Oval Office with some of these eminent researchers, but she refused to attend.) Journalists caricatured their proposals as a callous “let it rip” strategy, portraying Atlas as an unqualified ideologue, unconcerned about the spread of the virus. Some of the false accusations in the press came from anonymous sources on the Task Force—presumably Fauci and Birx, Atlas writes, though Fauci denied it when Atlas confronted him. On the record, Fauci dismissed Atlas as an “outlier,” an assessment that journalists reinforced by repeatedly noting that he was “not an epidemiologist,” as if that were the only relevant qualification for determining overall public-health policies.
Fauci, Birx, and Redfield were not epidemiologists, either, but they were enshrined as “the science” because they provided what mainstream journalists craved: scare stories that boosted ratings and made Trump look bad. During his first meeting with Trump, Atlas writes, the president told him, “I’m sure you will teach me many things while you’re here. But there is only one thing you’ll learn from me. Only one. You will learn how vicious, how biased, how unfair the media is.” Atlas soon came to agree, as he endured personal smears and watched relentlessly alarmist coverage of the pandemic: “No opportunity to inﬂame the voters was going to be missed by what I now believe are the most despicable group of unprincipled liars one could ever imagine—the American media.”
Atlas says that Trump and senior White House aides told him privately that they disagreed with the troika’s policies, and some wanted to fire Birx because she was so stubborn and defensive. (Atlas tells how, after he contradicted her during a meeting in the Oval Office, she “threw a fit” and screamed at him, “Never do that again! And in the Oval!”) But the aides feared that firing any of the troika, or even disagreeing openly, would cause a media firestorm and doom Trump’s reelection. “We must not rock the boat” was their mantra, Atlas writes. “To which I would reply, ‘The boat is frigging capsized.’”
The politician who comes off best is Florida governor Ron DeSantis, who had, Atlas observes, “a far more detailed understanding of the pandemic than anyone I had encountered in the Task Force.” Trump comes off fairly well, too, in his conversations with Atlas, as he frets about the harms of the lockdowns and instinctively recognizes the futility of the troika’s strategies. But Atlas lays the ultimate blame for the lockdowns—“a crime against humanity”—on Trump himself, because he allowed Birx and her allies to remain in charge. “This president, widely known for his signature ‘You’re fired!’ declaration, was misled by his closest political intimates,” Atlas writes. “All for fear of what was inevitable anyway—skewering from an already hostile media.”
When he resigned from the Task Force in a telephone call to Trump, Atlas writes, the president told him, “You were right about everything, all along the way. And you know what? You were also right about something else. Fauci wasn’t the biggest problem of all of them. It really wasn’t him.” Trump meant that it was Birx, and Atlas couldn’t resist a parting shot at the aides who had been so afraid of her. Knowing that they were listening on the speakerphone in the Oval Office, Atlas said, “Well, Mr. President, I will say this. You have balls. I have balls. But the closest people around you—they didn’t. They had no balls. They let you down.” They let down the rest of the country, too.
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