Who should go?

We don’t yet know who won the election, but whomever is in charge I feel it is an appropriate time to change the government’s COVID-19 leadership. Clearly if there is a new president there will be changes, and President Trump has suggested he will make changes if he remains in office.

New leadership will be important in the coming few months to effectively support the rollout of an approved vaccine. It actually may be crucial, however, if we don’t have a vaccine and we need to plan a longer term pandemic response.

I will divide this discussion into two parts. Tonight will be the easy calls; people I believe have not served our country or its government well. Tomorrow will be the more difficult calls; people who have some value but will likely need to be replaced

Easy Calls:

Alex Azar:  Secretary of Health and Human Services.

Mr. Azar is a former pharmaceutical lobbyist who seems to have exerted personal influence over almost every decision on COVID-19. Remarkably, he has provided little value and much disruption to the whole effort. He’s run roughshod over agencies that normally are viewed as independent, such as the FDA and CDC, even tinkering with policy announcements. Most disconcertingly, he attempted to assert personal control over the approval process for COVID-19 vaccines while at the same time overlooking conflict of interest issues with the people that he’s put in charge of activities such as “operation warp speed.” Despite his pharma background and his insistence on controlling every aspect of HHS he appears to lack any insight into the technical and regulatory issues that he oversees.

Robert Redfield, MD. Director, Centers for Disease Control.

Dr. Redfield has undermined his own agency at almost every turn. He has allowed it to become politicized to the point that his spokespeople are political appointees rather than technical experts at the agency. He also has shown little ability to protect or support the people who are actually doing the work in his agency. Then there are the multiple disasters that have occurred at the CDC under his watch. The 6-week long mishandling of assays to detect the coronavirus in February and March probably cost many lives. The haphazard release of new guidelines and advisories, some which had to be immediately withdrawn, have helped to undermine confidence in the government’s efforts. Reports are that morale among the few remaining agency leaders is very low. It is unlikely Dr. Redfield could reengage the agency in any meaningful way and he should leave as soon as possible.

Adm. Brent Giroir, Assistant Secretary for health.

Adm. Giroir, who has no prior military or public health experience to support his appointment or rank, has been in charge of the coronavirus testing program for the nation. That fact in and of itself should justify his departure. He is a pediatrician who has no technical background in testing or public health, and was forced out of his last job developing vaccines. But he is a remarkable political animal who has been effective in blaming others for his failures and undermining attempts to marginalize his presence. He should be made to leave quickly since there is some discussion that he would be made head of the FDA if Stephen Hahn were to leave. This would be the ultimate example of the Peter principle!

Again, this is based on my opinion, without input from anyone else. So (as usual) you can blame only me!

Published by jbakerjrblog

Immunologist, former Army MD, former head of allergy and clinical immunology at University of Michigan, vaccine developer and opinionated guy.

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