The Sept. 11 email exchange between Alexander and other officials centered on an embargoed CDC bulletin set to publish the following week and which Alexander — an unpaid assistant professor at Canada’s McMaster University who was recruited by longtime Trump operative Michael Caputo — said contained faulty science. For instance, defining teenagers aged 18 and older as “pediatric” patients was “misleading,” Alexander wrote to Charlotte Kent, the editor-in-chief of the CDC’s Morbidity and Mortality Weekly Reports. Alexander also said that the document wrongly conflated the risks of the coronavirus to young children and older adolescents, urging Kent to make multiple changes to the document.
“[I]f we change the title and how the cases are described, there could be an erroneous perception that we are being influenced,” Kent wrote on Sept. 14 to Anne Schuchat, the CDC’s no. 2 official and the agency’s top civil servant.
The final version of the CDC’s report, published on Sept. 15, contained revisions approved by career officials like Schuchat but also in line with those sought by Alexander. For instance, the report’s title was changed to remove the words “Children, Adolescents, and Young Adults” and replace them with “Persons.” Meanwhile, the word “pediatric,” which had appeared three times in the draft summary, did not appear in the published version of the equivalent paragraph, among other changes in the final version.
“Careful monitoring of SARS-CoV-2 infections, deaths, and other severe outcomes among persons aged <21 years remains particularly important as schools reopen in the United States,” according to the published report. The draft version of that sentence, reviewed by POLITICO, used the words “children, adolescents, and young adults” instead of “persons.”
The report went on to break down health and demographic data about young people who died of Covid-19.
The episode is the latest example of how Trump appointees’ interference has rippled across the health department — and how even when career experts can find common ground with political officials, they have been tainted by the unprecedented efforts to shape their findings.
One current and two former CDC officials who reviewed the email exchange between Alexander and Kent said they were troubled by the intervention to alter scientific reports viewed as untouchable prior to the Trump administration. The resulting changes also appeared to minimize the risks of the coronavirus to children by making the report’s focus on children less clear, two individuals said.
Alexander’s emails on the CDC’s bulletins are also a further indication of how administration officials have mounted a concerted effort to play down language about the risks of the coronavirus to children. White House coronavirus coordinator Deborah Birx separately pressed the CDC to adjust its guidance to reopen schools, The New York Times reported last week.
CDC defended the revisions to the MMWR as science-based. Kent said in a statement that the changes were made based on an “internal clearance process, not based on any comments from outside CDC.”
“This wording issue was flagged by CDC scientific reviewers as part of the routine internal clearance process for MMWR reports,” she said in a statement. “They noted, and MMWR editorial staff agreed, that the change should be made for clarity and to make the wording consistent with other scientific characterizations of age.”
They also unanimously raised concerns about why Alexander — who had served as Caputo’s hand-picked science adviser before Caputo went on medical leave Sept. 16 — was requesting changes in the scientific bulletin.
The CDC has spent decades maintaining a firewall around the MMWR reports, which officials said is intended to protect its scientists from political pressures. Three former editors-in-chief of the MMWR reports warned last month that even the implication of political pressure could tarnish the famed journals’ influence and scientists’ trust in the findings. The reports are influential in shaping global public health strategies. Fauci, the infectious-disease expert, has credited a 1981 MMWR that broke the news of HIV with changing the shape of his career.
But current and former CDC officials have said the agency is already facing regular pressure that threatens to compromise its operations.
“CDC science should not be undermined nor the voices of its experts muted, or our nation will suffer a crisis of confidence and trust that will continue to hamper our recovery from this pandemic,” Richard Besser, the president of the Robert Wood Johnson Foundation and the former acting CDC director, wrote in the Scientific American last month. “We cannot let this happen.”