Dr. Robert Redfield, eyes closed and searching for words, explained to Congress why the health agency he leads had softened coronavirus protections for slaughterhouse workers.

The White House, meatpacking industry and other federal agencies were not involved, the director of the Centers for Disease Control and Prevention insisted during the September hearing.

None of that was true.

Redfield was sitting in the White House when he instructed his staff to change a series of safety recommendations to suggestions, adding dozens of qualifiers such as “if feasible” and “not required.” He turned to a West Wing aide and told her the edits came directly from Vice President Mike Pence’s chief of staff.

Smithfield Foods, the South Dakota meatpacking plant under scrutiny, had seen the tougher recommendations, one of the first documents outlining COVID-19 protections for the industry. The CDC emailed it the day before the edits were made. Federal agriculture and labor officials also weighed in.

Redfield’s actions in overruling the CDC scientists who had spent a week investigating and writing the original guidance fit a pattern defining his leadership during the COVID-19 crisis. He has repeatedly allowed politics to undermine scientific best practices — and then publicly denied it.

The CDC started the COVID-19 crisis as the world’s public health gold standard, a beacon for other countries responding to their own outbreaks. Polls show more than eight in 10 Americans trusted its coronavirus information in early spring, before states across the country began reopening. The agency earned that respect through decades of shielding its scientific independence from the politics of Washington.

Since then, the country’s faith in the CDC’s coronavirus guidance has evaporated by double digits. President Donald Trump has undermined the agency by airing his own mistrust in it. And CDC scientists and staff have increasingly expressed their deep concerns over Redfield’s leadership and the state of the agency.

The election of a Democratic president may put a timestamp on Redfield’s tenure. But the CDC’s leadership remains critical during the transition weeks. President-elect Joe Biden moved fast this week to highlight Redfield’s statements that masks will be American’s best safeguard against the virus, even after a vaccine debuts — remarks that had drawn Trump’s ire.

But experts both inside the agency and out fear Redfield’s failures already have irreparably scarred American public health institutions, with life and death implications for a winter surge of outbreaks.
Dr. Richard Besser, former CDC acting director
“The integrity of the agency has been compromised. That falls to the director of CDC.”
“The integrity of the agency has been compromised,” said former CDC acting director Dr. Richard Besser. “That falls to the director of CDC.”

USA TODAY interviewed dozens of Redfield’s current and former colleagues, as well as his critics, supporters and an array of public health officials. Reporters reviewed internal CDC communications and more than 45 hours of his statements at the Capitol and in television and radio interviews. While Redfield’s capitulation to the White House has received attention throughout the pandemic, this reporting provides the most comprehensive portrait of the nation’s public health leader as his credibility unravels. 

Redfield forged his career on the front lines of the HIV/AIDS epidemic as a military doctor. He had aspired to be the CDC director since at least the early 2000s. After landing the post, he seemed on track for success with the launch of a federal initiative to end AIDS. 

Dr. Robert Redfield seen through a door window at the Senate appropriations subcommittee hearing about coronavirus response efforts on Sept. 16.
ANDREW HARNIK, AP
When a once-in-a-century pandemic exploded this past winter, Redfield, a devout Catholic, told friends that answering the crisis felt like his calling. For 10 months, he has sought a middle ground between staying in the Trump administration’s good graces and promoting the CDC’s science.

Even colleagues sympathetic to his situation now worry that his failures could cast a long shadow over the agency. With each surrender behind closed doors and milquetoast public appearance, Redfield has alienated both his staff and politicians in Washington, records and interviews show.

In late September, Dr. William Foege, a former CDC director famous for eradicating smallpox, urged Redfield to orchestrate his own firing.

“Acknowledge the tragedy of responding poorly, apologize for what has happened and your role in acquiescing,” Foege wrote in a private letter to Redfield first reported by USA TODAY. “The public health texts of the future will use this as a lesson on how not to handle an infectious disease pandemic.”

Dr. William Foege, a former CDC director, in a private letter to Redfield
“Acknowledge the tragedy of responding poorly, apologize for what has happened and your role in acquiescing. The public health texts of the future will use this as a lesson on how not to handle an infectious disease pandemic.”

Climbing cases, waning credibility
The CDC director in the next administration will face a country increasingly distrustful of the agency’s coronavirus information, nonpartisan Kaiser Family Foundation polling shows. The drop has been especially dramatic among Republicans, whose faith in the CDC declined by 30 percentage points from April to September.

The erosion in credibility comes as the CDC may be needed most: The agency is leading efforts to distribute a COVID-19 vaccine even as infections are surging to record numbers. Virtually all states now are reporting rising case counts.

“When CDC says it, you can take it to the bank. What the administration has done, above CDC, is they have made that suspect,” said Dr. Georges Benjamin, executive director of the American Public Health Association. “That is what makes this issue with CDC so corrosive.”
Dr. Georges Benjamin, executive director of the American Public Health Association
“When CDC says it, you can take it to the bank. What the administration has done, above CDC, is they have made that suspect. That is what makes this issue with CDC so corrosive.”
In the most troubling cases this year, Redfield pressured local health officers to grant favors to politicians and businesses, records show. He has allowed political appointees outside the agency to write and publish information on the CDC’s website — sometimes over the objections of his top scientists and without technical review.

Hours before the CDC was to release school-reopening guidelines in August, the White House revised the document’s introduction, downplaying health concerns and encouraging schools to reopen, according to three health officials involved. CDC’s school safety experts did not even have time to read the whole document before it went online. 

“We didn’t feel like we had a choice” whether to publish, one of the officials told USA TODAY about the episode, first reported by the New York Times. CDC officials spoke on the condition of anonymity because they were not authorized to discuss the meetings.

Amid the delays and confusion, local politics — not clear scientific guidance — largely determined which students are back in the classroom and which are learning online.

Industry executives and lobbyists have repeatedly called up allies throughout the administration who successfully pushed the CDC into diluting and delaying guidance. 

At the urging of cruise companies, the White House pressured the CDC to hold up the agency’s sailing ban in March. Explicit warnings about the duration of the ban were removed from subsequent extensions of the ban. At least four ships cast off in the week before the original no-sail order and went on to experience COVID-19 outbreaks while at sea.  

Centers for Disease Control and Prevention Director Dr. Robert Redfield at a Senate Appropriations subcommittee hearing on a “Review of Coronavirus Response Efforts” on Sept. 16.
ANDREW HARNIK, AP
Two federal officials recalled conversations about the orders with a visibly frustrated Dr. Martin Cetron, the agency’s director of global migration and quarantine. Olivia Troye, one of Pence’s former top aides who worked directly with the CDC, remembers Cetron telling her: “We are going to kill Americans.” 

Now CDC employee surveys show morale so low that fewer infectious disease experts are willing to volunteer to leave their regular duties and deploy to rural communities, said a senior CDC official with access to the data. The official, like others interviewed by USA TODAY, blames Redfield’s deference to the White House. 

“My staff have no respect for him,” the official said.

Under Redfield, political appointees outside the agency started screening the CDC’s weekly scientific journal, used to inform doctors and scientists nationally. Many of his employees, who consider those reports sacrosanct, thought he had crossed the Rubicon. 

“You’d expect the head of CDC to forcefully defend our agency,” another senior official said in an interview. “That’s really frustrating for people who have spent their life doing this work.”

After Politico first reported on the interference, Redfield told Congress the journal’s scientific integrity had not been compromised.