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President Donald Trump and Health and Human Services Secretary Alex Azar.
Photo: Alex Brandon (AP)

Health and Human Services Secretary Alex Azar appointed an aide with “minimal public health experience” and who had spent the six years prior to joining the agency running a dog breeding business to head its coronavirus response in mid-January, Reuters reported on Wednesday. Sources said decisions made by that official contributed to a scarcity of test kits that has persisted even as confirmed cases in the U.S. have grown to over 800,000.

The appointment followed a Jan. 21 appearance on Fox News where Azar reassured the public the Centers for Disease Control and Prevention had “developed a diagnostic test” that would be rolled out across the country and the disease was “one for which we have a playbook.” Per Reuters, not long after that appearance Azar selected aide Brian Harrison to “lead the agency’s day-to-day response to COVID-19.” Harrison had minimal public health experience and no formal education in related fields before joining the Trump administration in January 2018, aside from a one-year gig as a “Confidential Assistant” to Azar in 2006, when Azar was George W. Bush’s HHS deputy secretary. From 2012 to 2018 he ran a company called Dallas Labradoodles.

Harrison was promoted to Azar’s chief of staff in summer 2019 and, according to Reuters, five sources confirmed other officials regularly referred to him by the dismissive nickname “the dog breeder.” One of his decisions was allegedly to exclude the Food and Drug Administration and its chief Dr. Stephen Hahn from initial participation on Trump’s coronavirus task force, which included the CDC, National Institutes of Health, Office of Global Affairs, and Assistant Secretary for Preparedness and Response. (HHS denied that Harrison had made that decision to Reuters, though Vice President Mike Pence quickly added the FDA and Hahn to the task force when he was assigned to it on February 26.)

According to Reuters, NIH director Dr. Anthony Fauci was uncertain whether the task force really needed to include the FDA, as at that time the Chinese government claimed the virus was spread via animals and the FDA works to “expedite drugs or devices.”

That obviously ended up being untrue. Two sources told the news agency that the FDA’s exclusion directly affected its ability to update the White House on how testing was going, which was not well. The CDC and FDA took over a month to come up with viable tests, with the initial version resulting in false positives, and the result was a massive shortage that is still thwarting efforts to track the virus. According to Reuters, a senior government official said that Azar was also “flat-out wrong” on the availability of reliable test kits and failed to convey the scale of the national shortage of personal protective equipment.

According to the Wall Street Journal, Azar’s defenders have suggested the White House is scapegoating him for their own failures to take the outbreak seriously, but administration officials were alarmed by a lack of effective coordination between government agencies under Azar and the decision to exclude the FDA from the task force. (Warning signs that stockpiles of PPE might run out were apparent early in the worldwide outbreak.) Per the Washington Post, the CDC’s initial failure to develop a reliable test was compounded by bureaucratic red tape at the FDA, both hindering the CDC test’s distribution and delaying development of alternatives by medical researchers.

It wasn’t until late February when Trump finally put a White House official, Pence, in charge of the coronavirus task force. On February 27, Fauci called Harrison and told him to speed development of new tests, after which Harrison “convened a teleconference of officials from the FDA, CDC and other agencies,” according to the Post. The FDA loosened rules to allow clinical labs outside the government to test for the virus on February 29, the same day the first death from the virus in the U.S. was reported.

Pence’s assignment to the task force was widely seen as evidence the Trump administration had lost confidence in Azar’s ability to handle the crisis alone.

“Clearly there was a need for better coordination of the FDA and CDC and other agencies,” former Harvard Medical School dean Jeffrey Flier told Reuters. “HHS has to be operating effectively in a crisis like this.”

“Testing is the crack that split apart the rest of the response, when it should have tied everything together,” Dr. Nahid Bhadelia, who heads the Boston University School of Medicine’s Special Pathogens Unit, told the New York Times. “… The delay of the testing has impacted the response across the board.”

In a statement to Reuters, Harrison declined to answer questions about his oversight of the task force but wrote, “Americans would be well served by having more government officials who have started and worked in small family businesses and fewer trying to use that experience to attack them and distort the record.” 

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