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    U.S. Failed to Safeguard Many Migrant Children, Review Finds

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    Many sponsors were inadequately vetted and safety checks went unfulfilled, an independent watchdog found. Children ended up in dangerous jobs across the country.An independent government watchdog found serious lapses at the Department of Health and Human Services in its protection of children who migrate to the United States on their own, according to a report released Thursday.H.H.S., the federal agency responsible for sheltering migrant children when they arrive by themselves, repeatedly handed them over to adult sponsors in the United States without thorough vetting and sometimes failed to conduct timely safety checks on children once they were released, said the report by the department’s inspector general.“I would define these gaps as very serious,” said Haley Lubeck, the project leader for the review. “We know that these children are especially vulnerable to exploitation.”The findings echoed New York Times reporting that the screening of sponsors and other safeguards for migrant children broke down during the first years of the Biden administration as hundreds of thousands of children crossed the border amid a pandemic-era economic collapse in parts of Central America. Migrant children have ended up working dangerous industrial jobs in violation of child labor laws across the country — in slaughterhouses, factories, construction sites and elsewhere, The Times found. Some have been gravely injured or killed.The report follows a June audit that H.H.S. conducted in response to Times reporting that found that many children were living with strangers who expected or even forced them to work. That audit revealed that government case workers had released more than 340 migrant children to adults who were sponsoring three or more children who were not family members.In early 2021, record numbers of children started crossing the border faster than H.H.S. could process them. With no room left in shelters, many children stayed on cots in crowded tents, sparking public outrage. The Biden administration pressured staff members to move the children out of shelters more quickly, and government workers said they saw children being sent to adults who clearly intended to put them to work.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Harris Begins a Reproductive Rights Tour on 51st Anniversary of Roe

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      The administration’s task force on reproductive rights also announced what officials said were new steps to help Americans get contraceptives and abortions under an emergency care law.Vice President Kamala Harris will travel to Wisconsin on Monday morning to host an event in support of abortion rights while President Biden brings together a task force on reproductive health care in Washington.Both events are designed to call attention to the 51st anniversary of Roe v. Wade, the landmark Supreme Court ruling that established a constitutional right to abortion, and to announce new steps that Mr. Biden’s administration has taken to support abortion access since the court struck it down in 2022.“Even as Americans — from Ohio to Kentucky to Michigan to Kansas to California — have resoundingly rejected attempts to limit reproductive freedom, Republican elected officials continue to push for a national ban and devastating new restrictions across the country,” Mr. Biden said in a statement. “On this day and every day, Vice President Harris and I are fighting to protect women’s reproductive freedom.”Ms. Harris, who has become the administration’s most vocal defender of abortion rights, chose Wisconsin as the backdrop for the first in a series of abortion rights events her office has planned around the country through the spring. Kirsten Allen, the vice president’s press secretary, said that Ms. Harris’s office had planned several more stops, over the next two to three months, in “states that have enshrined protections, restricted access and states that continue to threaten access, causing chaos and confusion.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber?  More

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      White House Considers Lifting Rule That Blocked Migrants During Pandemic

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      Among the plans under consideration is whether to give migrant families a chance to apply for protections, and to possibly lifting the public health rule for single adults this summer.WASHINGTON — The Biden administration is in the later stages of planning how to phase out a Trump-era public health rule that has allowed border agents to rapidly turn away most migrants who have arrived at the southern border during the pandemic, according to two administration officials. It is possible that in the coming weeks, border officials could start allowing migrant families back into the country, with an eye toward lifting the rule for single adults this summer.The plan, while still not final, is sure to ​complicate an already thorny issue for President Biden and Vice President Kamala Harris, who is visiting the border on Friday as Republicans accuse the administration of being slow to address what they describe as an unrelenting surge of migrants trying to enter the country. Lifting the rule will only exacerbate that.Since the beginning of the pandemic, border agents have turned away migrants nearly 850,000 times under the public health rule, known as Title 42, which immigration and human rights advocates call unnecessary and cruel, particularly for those seeking asylum. Migrant families have been turned away more than 80,000 times since the rule was put in place in March 2020, according to government data.The White House has deflected questions about how much longer the rule will remain in place, saying it is up to the Centers for Disease Control and Prevention, which issued the policy. An agency spokeswoman referred questions about the rule to the White House.Mr. Biden, who has promised a more humane approach to immigration enforcement, decided not to continue the Trump administration’s policy of expelling children who arrived alone at the border. Single adults and many families, however, have continued to be turned away because of the public health rule, whose stated purpose is to prevent the coronavirus from spreading at points of entry or Border Patrol stations. Still, some migrant families have been allowed into the United States because Mexico or their home countries refuse to take them back.Despite the measured approach, lifting the rule — which many public health experts say has little point this late in the pandemic — is likely to sharply increase the flow of migrants, at least in the short term. That would force Mr. Biden to address the issue without compromising his pledge to take a more compassionate approach to enforcing immigration laws.Plans to lift the rule have been under discussion for weeks, but there appears to be a fresh sense of urgency; officials familiar with the evolving plan shared details with The New York Times on the condition of anonymity because they were not authorized to discuss it. Axios earlier reported some of the details.For migrant families, the officials said, one idea under consideration is to put those seeking asylum into one of Immigration and Customs Enforcement’s alternatives to detention. That includes having them wear ankle bracelets as their request makes its way through the immigration system, a process that can take years because of a chronic backlog of cases. The administration has already been doing this for other migrant families this year.The administration is considering placing families who do not make asylum claims in the queue for expedited removal, a process that allows immigration officers to deport people without a hearing, a lawyer or a right of appeal in some cases.One official familiar with the plans said that all the ideas under consideration included health and safety measures to avoid the spread of the virus.Lifting the public health rule for single adults is likely to come later, according to the most recent discussions, possibly by the end of the summer. Single adults have been barred from entering the country more than 262,000 times since the rule went into effect. The administration is still debating where these migrants would go once they enter the country, including whether to place them in expedited removal or in home detention so as to avoid a detention center, as Mr. Biden campaigned against mass incarceration of undocumented immigrants.Representative Henry Cuellar of Texas, a senior Democrat on the House Appropriations Subcommittee on Homeland Security, said border officials had been bracing for an end to the public health rule and other pandemic restrictions, including a ban on nonessential cross-border commercial traffic that was recently extended until July 21.President Biden has promised a more humane approach to immigration enforcement and started to allow children who arrived alone at the border to enter the country.Pete Marovich for The New York Times“That could be, according to them, ‘a perfect storm,’ because all of a sudden all those people will be coming into the U.S.,” Mr. Cuellar said.The Biden administration is trying to avoid just such a storm with a phased-in approach.Another challenge for the administration is that detention centers overseen by Immigration and Customs Enforcement are filling up, holding nearly 27,000 as of Thursday. That is a 90 percent jump compared with the average number of detainees in March, according to government data. If the administration lifts the health rule entirely, it would face the question of where to house the migrants, caught between significantly increasing the number of detained immigrants and releasing everyone to wait for court proceedings.Lifting the public health rule for families, though, will make it hard for the administration to defend keeping it in place for single adults.“This piecemeal approach doesn’t cut it,” said Denise Bell, a researcher for Amnesty International’s refugee and migrant rights program. “How many carve-outs until you have to admit there is no good public health rationale for Title 42?”Lifting the public health rule could lead to some bottlenecks along the border, but it could also ease pressure on the Department of Health and Human Services, which is overseeing the care of unaccompanied migrant children who have been arriving in record numbers.As of Thursday, about 14,500 such children were being held in government shelters, according to internal government data obtained by The Times, as officials try to place them with family members or other sponsors in the United States. Nearly half of the children are staying in emergency shelters where some conditions are far below government standards; the average stay is currently 37 days.“When families were pushed back, sometimes they’d make that extraordinarily difficult choice to send their child ahead, with the hope that as an unaccompanied child migrating alone, they’d have a better chance of being accepted and processed through,” said Wendy Young, the president of a nonprofit, Kids in Need of Defense. “It’s a horrible choice that families have to make, but we did see families doing exactly that.”Without the public health rule, families may again start trying to cross the border together — a better option, Ms. Young said, than being placed in the large emergency shelters overseen by the health and human services department.Ms. Harris, who will travel to El Paso on Friday with Alejandro N. Mayorkas, the homeland security secretary, is leading the administration’s efforts to help improve conditions in Central America, where many of the children are coming from, to deter migration.For weeks, Republicans have pressed Ms. Harris about why she traveled to Central America this month, but not to the American side of the border with Mexico. Her visit comes just days before Mr. Trump goes to the border with a group of Republicans, including Gov. Greg Abbott of Texas, who has pledged to finish Mr. Trump’s border wall in his state after Mr. Biden halted construction. Mr. Abbott has also threatened to kick thousands of migrant children out of shelters there. More

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      In Trump’s Final Chapter, a Failure to Rise to the Covid-19 Moment

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      #masthead-section-label, #masthead-bar-one { display: none }Covid-19 VaccinesVaccine QuestionsDoses Per StateAfter Your VaccineHow the Moderna Vaccine WorksWhy You’ll Still Need a MaskAdvertisementContinue reading the main storySupported byContinue reading the main story‘Covid, Covid, Covid’: In Trump’s Final Chapter, a Failure to Rise to the MomentAs the U.S. confronted a new wave of infection and death through the summer and fall, the president’s approach to the pandemic came down to a single question: What would it mean for him?President Trump not only ended up soundly defeated by Joseph R. Biden Jr., but missed his chance to show that he could meet the defining challenge of his tenure.Credit…Doug Mills/The New York TimesMichael D. Shear, Maggie Haberman, Noah Weiland, Sharon LaFraniere and Dec. 31, 2020Updated 9:57 p.m. ETWASHINGTON — It was a warm summer Wednesday, Election Day was looming and President Trump was even angrier than usual at the relentless focus on the coronavirus pandemic.“You’re killing me! This whole thing is! We’ve got all the damn cases,” Mr. Trump yelled at Jared Kushner, his son-in-law and senior adviser, during a gathering of top aides in the Oval Office on Aug. 19. “I want to do what Mexico does. They don’t give you a test till you get to the emergency room and you’re vomiting.”Mexico’s record in fighting the virus was hardly one for the United States to emulate. But the president had long seen testing not as a vital way to track and contain the pandemic but as a mechanism for making him look bad by driving up the number of known cases.And on that day he was especially furious after being informed by Dr. Francis S. Collins, the head of the National Institutes of Health, that it would be days before the government could give emergency approval to the use of convalescent plasma as a treatment, something Mr. Trump was eager to promote as a personal victory going into the Republican National Convention the following week.“They’re Democrats! They’re against me!” he said, convinced that the government’s top doctors and scientists were conspiring to undermine him. “They want to wait!”Throughout late summer and fall, in the heat of a re-election campaign that he would go on to lose, and in the face of mounting evidence of a surge in infections and deaths far worse than in the spring, Mr. Trump’s management of the crisis — unsteady, unscientific and colored by politics all year — was in effect reduced to a single question: What would it mean for him?The result, according to interviews with more than two dozen current and former administration officials and others in contact with the White House, was a lose-lose situation. Mr. Trump not only ended up soundly defeated by Joseph R. Biden Jr., but missed his chance to show that he could rise to the moment in the final chapter of his presidency and meet the defining challenge of his tenure.Efforts by his aides to persuade him to promote mask wearing, among the simplest and most effective ways to curb the spread of the disease, were derailed by his conviction that his political base would rebel against anything that would smack of limiting their personal freedom. Even his own campaign’s polling data to the contrary could not sway him.His explicit demand for a vaccine by Election Day — a push that came to a head in a contentious Oval Office meeting with top health aides in late September — became a misguided substitute for warning the nation that failure to adhere to social distancing and other mitigation efforts would contribute to a slow-rolling disaster this winter.His concern? That the man he called “Sleepy Joe” Biden, who was leading him in the polls, would get credit for a vaccine, not him.The government’s public health experts were all but silenced by the arrival in August of Dr. Scott W. Atlas, the Stanford professor of neuroradiology recruited after appearances on Fox News.With Dr. Deborah L. Birx, the coordinator of the White House virus task force, losing influence and often on the road, Dr. Atlas became the sole doctor Mr. Trump listened to. His theories, some of which scientists viewed as bordering on the crackpot, were exactly what the president wanted to hear: The virus is overblown, the number of deaths is exaggerated, testing is overrated, lockdowns do more harm than good.The president has long seen testing not as a vital way to track and contain the pandemic but as a mechanism for making him look bad by driving up the number of known cases.Credit…William DeShazer for The New York TimesAs the gap between politics and science grew, the infighting that Mr. Trump had allowed to plague the administration’s response from the beginning only intensified. Threats of firings worsened the leadership vacuum as key figures undercut each other and distanced themselves from responsibility.The administration had some positive stories to tell. Mr. Trump’s vaccine development program, Operation Warp Speed, had helped drive the pharmaceutical industry’s remarkably fast progress in developing several promising approaches. By the end of the year, two highly effective vaccines would be approved for emergency use, providing hope for 2021.The White House rejected any suggestions that the president’s response had fallen short, saying he had worked to provide adequate testing, protective equipment and hospital capacity and that the vaccine development program had succeeded in record time.“President Trump has led the largest mobilization of the public and private sectors since WWII to defeat Covid-19 and save lives,” said Brian Morgenstern, a White House spokesman.But Mr. Trump’s unwillingness to put aside his political self-centeredness as Americans died by the thousands each day or to embrace the steps necessary to deal with the crisis remains confounding even to some administration officials. “Making masks a culture war issue was the dumbest thing imaginable,” one former senior adviser said.His own bout with Covid-19 in early October left him extremely ill and dependent on care and drugs not available to most Americans, including a still-experimental monoclonal antibody treatment, and he saw firsthand how the disease coursed through the White House and some of his close allies.Yet his instinct was to treat that experience not as a learning moment or an opportunity for empathy, but as a chance to portray himself as a Superman who had vanquished the disease. His own experience to the contrary, he assured a crowd at the White House just a week after his hospitalization, “It’s going to disappear; it is disappearing.”Weeks after his own recovery, he would still complain about the nation’s preoccupation with the pandemic.“All you hear is Covid, Covid, Covid, Covid, Covid, Covid, Covid, Covid, Covid, Covid, Covid,” Mr. Trump said at one campaign stop, uttering the word 11 times.In the end he could not escape it.Supporters of Mr. Trump outside Walter Reed National Military Medical Center, where he was treated for the coronavirus, in October. He largely rejected aides’ efforts to use his bout with the illness to demonstrate a new compassion.Credit…Oliver Contreras for The New York Times‘The Base Will Revolt’By late July, new cases were at record highs, defying Mr. Trump’s predictions through the spring that the virus was under control, and deaths were spiking to alarming levels. Herman Cain, a 2012 Republican presidential candidate, died from the coronavirus; the previous month he had attended a Trump rally without a mask.With the pandemic defining the campaign despite Mr. Trump’s efforts to make it about law and order, Tony Fabrizio, the president’s main pollster, came to the Oval Office for a meeting in the middle of the summer prepared to make a surprising case: that mask wearing was acceptable even among Mr. Trump’s supporters.Arrayed in front of the Resolute Desk, Mr. Trump’s advisers listened as Mr. Fabrizio presented the numbers. According to his research, some of which was reported by The Washington Post, voters believed the pandemic was bad and getting worse, they were more concerned about getting sick than about the virus’s effects on their personal financial situation, the president’s approval rating on handling the pandemic had hit new lows and a little more than half the country did not think he was taking the situation seriously.But what set off debate that day was Mr. Fabrizio’s finding that more than 70 percent of voters in the states being targeted by the campaign supported mandatory mask wearing in public, at least indoors, including a majority of Republicans.Mr. Kushner, who along with Hope Hicks, another top adviser, had been trying for months to convince Mr. Trump that masks could be portrayed as the key to regaining freedom to go safely to a restaurant or a sporting event, called embracing mask-wearing a “no-brainer.”Mr. Kushner had some reason for optimism. Mr. Trump had agreed to wear one not long before for a visit to Walter Reed National Military Medical Center, after finding one he believed he looked good in: dark blue, with a presidential seal.But Mark Meadows, the White House chief of staff — backed up by other aides including Stephen Miller — said the politics for Mr. Trump would be devastating.“The base will revolt,” Mr. Meadows said, adding that he was not sure Mr. Trump could legally make it happen in any case.The president removed his mask upon arriving at the White House on Oct. 5, after being hospitalized with Covid-19. He was rarely seen wearing one again.Credit…Anna Moneymaker for The New York TimesThat was all Mr. Trump needed to hear. “I’m not doing a mask mandate,” he concluded.Aside from when he was sick, he was rarely seen in a mask again.The president had other opportunities to show leadership rather than put his political fortunes first..css-fk3g7a{font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:0.875rem;line-height:1.125rem;color:#121212 !important;}@media (min-width:740px){.css-fk3g7a{font-size:0.9375rem;line-height:1.25rem;}}.css-1sjr751{-webkit-text-decoration:none;text-decoration:none;}.css-1sjr751 a:hover{border-bottom:1px solid #dcdcdc;}.css-rqynmc{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:0.9375rem;line-height:1.25rem;color:#333;margin-bottom:0.78125rem;}@media (min-width:740px){.css-rqynmc{font-size:1.0625rem;line-height:1.5rem;margin-bottom:0.9375rem;}}.css-rqynmc strong{font-weight:600;}.css-rqynmc em{font-style:italic;}.css-zs9392{margin:10px auto 5px;font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:1.125rem;line-height:1.3125rem;color:#121212;}@media (min-width:740px){.css-zs9392{font-size:1.25rem;line-height:1.4375rem;}}#NYT_BELOW_MAIN_CONTENT_REGION .css-zs9392{font-family:nyt-cheltenham,georgia,’times new roman’,times,serif;font-weight:700;font-size:1.375rem;line-height:1.75rem;margin-bottom:20px;}@media (min-width:740px){#NYT_BELOW_MAIN_CONTENT_REGION .css-zs9392{font-size:1.5rem;line-height:1.875rem;}}.css-121grtr{margin:0 auto 10px;}.css-16ed7iq{width:100%;display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-align-items:center;-webkit-box-align:center;-ms-flex-align:center;align-items:center;-webkit-box-pack:center;-webkit-justify-content:center;-ms-flex-pack:center;justify-content:center;padding:10px 0;background-color:white;}.css-pmm6ed{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-align-items:center;-webkit-box-align:center;-ms-flex-align:center;align-items:center;}.css-pmm6ed > :not(:first-child){margin-left:5px;}.css-5gimkt{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:0.8125rem;font-weight:700;-webkit-letter-spacing:0.03em;-moz-letter-spacing:0.03em;-ms-letter-spacing:0.03em;letter-spacing:0.03em;text-transform:uppercase;color:#333;}.css-5gimkt:after{content:’Collapse’;}.css-rdoyk0{-webkit-transition:all 0.5s ease;transition:all 0.5s ease;-webkit-transform:rotate(180deg);-ms-transform:rotate(180deg);transform:rotate(180deg);}.css-eb027h{max-height:5000px;-webkit-transition:max-height 0.5s ease;transition:max-height 0.5s ease;}.css-6mllg9{-webkit-transition:all 0.5s ease;transition:all 0.5s ease;position:relative;opacity:0;}.css-6mllg9:before{content:”;background-image:linear-gradient(180deg,transparent,#ffffff);background-image:-webkit-linear-gradient(270deg,rgba(255,255,255,0),#ffffff);height:80px;width:100%;position:absolute;bottom:0px;pointer-events:none;}#masthead-bar-one{display:none;}#masthead-bar-one{display:none;}.css-qmg6q8{background-color:white;margin:1.5rem auto 1.9rem;max-width:600px;}#NYT_BELOW_MAIN_CONTENT_REGION .css-qmg6q8{padding:0;width:calc(100% – 40px);max-width:600px;margin-right:auto;margin-left:auto;}.css-qmg6q8 strong{font-weight:700;}.css-qmg6q8 em{font-style:italic;}@media (min-width:740px){.css-qmg6q8{margin:40px auto;}}.css-qmg6q8:focus{outline:1px solid #e2e2e2;}.css-qmg6q8 a{color:#326891;-webkit-text-decoration:none;text-decoration:none;border-bottom:1px solid #ccd9e3;}.css-qmg6q8 a:visited{color:#333;-webkit-text-decoration:none;text-decoration:none;border-bottom:1px solid #ddd;}.css-qmg6q8 a:hover{border-bottom:none;}.css-qmg6q8[data-truncated] .css-rdoyk0{-webkit-transform:rotate(0deg);-ms-transform:rotate(0deg);transform:rotate(0deg);}.css-qmg6q8[data-truncated] .css-eb027h{max-height:300px;overflow:hidden;-webkit-transition:none;transition:none;}.css-qmg6q8[data-truncated] .css-5gimkt:after{content:’See more’;}.css-qmg6q8[data-truncated] .css-6mllg9{opacity:1;}.css-11uwurf{border:1px solid #e2e2e2;padding:15px;border-radius:0;margin:0 auto;overflow:hidden;}@media (min-width:600px){.css-11uwurf{padding:20px;}}#NYT_BELOW_MAIN_CONTENT_REGION .css-11uwurf{border-top:1px solid #121212;border-bottom:none;}Covid-19 Vaccines ›Answers to Your Vaccine QuestionsWith distribution of a coronavirus vaccine beginning in the U.S., here are answers to some questions you may be wondering about:If I live in the U.S., when can I get the vaccine? While the exact order of vaccine recipients may vary by state, most will likely put medical workers and residents of long-term care facilities first. If you want to understand how this decision is getting made, this article will help.When can I return to normal life after being vaccinated? Life will return to normal only when society as a whole gains enough protection against the coronavirus. Once countries authorize a vaccine, they’ll only be able to vaccinate a few percent of their citizens at most in the first couple months. The unvaccinated majority will still remain vulnerable to getting infected. A growing number of coronavirus vaccines are showing robust protection against becoming sick. But it’s also possible for people to spread the virus without even knowing they’re infected because they experience only mild symptoms or none at all. Scientists don’t yet know if the vaccines also block the transmission of the coronavirus. So for the time being, even vaccinated people will need to wear masks, avoid indoor crowds, and so on. Once enough people get vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we as a society achieve that goal, life might start approaching something like normal by the fall 2021.If I’ve been vaccinated, do I still need to wear a mask? Yes, but not forever. Here’s why. The coronavirus vaccines are injected deep into the muscles and stimulate the immune system to produce antibodies. This appears to be enough protection to keep the vaccinated person from getting ill. But what’s not clear is whether it’s possible for the virus to bloom in the nose — and be sneezed or breathed out to infect others — even as antibodies elsewhere in the body have mobilized to prevent the vaccinated person from getting sick. The vaccine clinical trials were designed to determine whether vaccinated people are protected from illness — not to find out whether they could still spread the coronavirus. Based on studies of flu vaccine and even patients infected with Covid-19, researchers have reason to be hopeful that vaccinated people won’t spread the virus, but more research is needed. In the meantime, everyone — even vaccinated people — will need to think of themselves as possible silent spreaders and keep wearing a mask. Read more here.Will it hurt? What are the side effects? The Pfizer and BioNTech vaccine is delivered as a shot in the arm, like other typical vaccines. The injection into your arm won’t feel different than any other vaccine, but the rate of short-lived side effects does appear higher than a flu shot. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. The side effects, which can resemble the symptoms of Covid-19, last about a day and appear more likely after the second dose. Early reports from vaccine trials suggest some people might need to take a day off from work because they feel lousy after receiving the second dose. In the Pfizer study, about half developed fatigue. Other side effects occurred in at least 25 to 33 percent of patients, sometimes more, including headaches, chills and muscle pain. While these experiences aren’t pleasant, they are a good sign that your own immune system is mounting a potent response to the vaccine that will provide long-lasting immunity.Will mRNA vaccines change my genes? No. The vaccines from Moderna and Pfizer use a genetic molecule to prime the immune system. That molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse to a cell, allowing the molecule to slip in. The cell uses the mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any moment, each of our cells may contain hundreds of thousands of mRNA molecules, which they produce in order to make proteins of their own. Once those proteins are made, our cells then shred the mRNA with special enzymes. The mRNA molecules our cells make can only survive a matter of minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a bit longer, so that the cells can make extra virus proteins and prompt a stronger immune response. But the mRNA can only last for a few days at most before they are destroyed.After he recovered from his bout with the virus, some of his top aides, including Mr. Kushner and Jason Miller, a senior campaign strategist, thought the illness offered an opportunity to demonstrate the kind of compassion and resolve about the pandemic’s toll that Mr. Trump had so far failed to show.When Mr. Trump returned from the hospital, his communications aides, with the help of Ivanka Trump, his daughter, urged him to deliver a national address in which he would say: “I had it. It was tough, it kicked my ass, but we’re going to get through it.”He refused, choosing instead to address a boisterous campaign rally for himself from the balcony of the White House overlooking the South Lawn.Mr. Trump never came around to the idea that he had a responsibility to be a role model, much less that his leadership role might require him to publicly acknowledge hard truths about the virus — or even to stop insisting that the issue was not a rampaging pandemic but too much testing.Alex M. Azar II, the health and human services secretary, briefed the president this fall on a Japanese study documenting the effectiveness of face masks, telling him: “We have the proof. They work.” But the president resisted, criticizing Mr. Kushner for pushing them and again blaming too much testing — an area Mr. Kushner had been helping to oversee — for his problems.“I’m going to lose,” Mr. Trump told Mr. Kushner during debate preparations. “And it’s going to be your fault, because of the testing.”Mr. Morgenstern, the White House spokesman, said that exchange between the president and Mr. Kushner “never happened.”Mr. Azar, who was sometimes one of the few people wearing a mask at White House events, privately bemoaned what he called a political, anti-mask culture set by Mr. Trump. At White House Christmas parties, Mr. Azar asked maskless guests to back away from him.Dr. Stephen M. Hahn, center, the commissioner of the Food and Drug Administration, Dr. Deborah L. Birx, the coordinator of the White House virus task force, and Alex M. Azar II, the secretary of health and human services, in the Oval Office in May. Conflicts on the president’s team only intensified as the year went on.Credit…Erin Schaff/The New York TimesDivisions and DisagreementsThe decision to run the government’s response out of the West Wing was made in the early days of the pandemic. The idea was to break down barriers between disparate agencies, assemble public health expertise and encourage quick and coordinated decision-making.It did not work out like that, and by fall the consequences were clear.Mr. Trump had always tolerated if not encouraged clashes among subordinates, a tendency that in this case led only to policy paralysis, confusion about who was in charge and a lack of a clear, consistent message about how to reduce the risks from the pandemic.Keeping decision-making power close to him was another Trump trait, but in this case it also elevated the myriad choices facing the administration to the presidential level, bogging the process down in infighting, raising the political stakes and encouraging aides to jockey for favor with Mr. Trump.The result at times was a systemwide failure that extended well beyond the president.“What we needed was a coordinated response that involved contributions from multiple agencies,” said Dr. Scott Gottlieb, who was commissioner of the Food and Drug Administration for the first two years of the Trump administration.“Someone needed to pull that all together early,” he said. “It wasn’t the job of the White House, either. This needed to happen closer to the agencies. That didn’t happen on testing, or on a whole lot of other things.”The relationship between Mr. Azar and Dr. Stephen M. Hahn, the commissioner of the Food and Drug Administration, grew increasingly tense; by early November, they were communicating only by text and in meetings.Dr. Birx had lost the clout she enjoyed early on in the crisis and spent much of the summer and fall on the road counseling governors and state health officials.Mr. Meadows was at odds with almost everyone as he sought to impose the president’s will on scientists and public health professionals. In conversations with top health officials, Mr. Meadows would rail against regulatory “bureaucrats” he thought were more interested in process than outcome.Some of the doctors on the task force, including Dr. Anthony S. Fauci and Dr. Robert R. Redfield, were reluctant to show up in person at the White House, worried that the disdain there for mask wearing and social distancing would leave them at risk of infection.Vice President Mike Pence was nominally in charge of the task force but was so cautious about getting crosswise with Mr. Trump as they battled for re-election that, in public at least, he became nearly invisible.The debates inside the White House increasingly revolved around Dr. Atlas, who had no formal training in infectious diseases but whose views — which Mr. Trump saw him deliver on Fox News — appealed to the president’s belief that the crisis was overblown.Dr. Scott W. Atlas, the Stanford professor of neuroradiology recruited after appearances on Fox News, became the sole doctor Mr. Trump listened to.Credit…Anna Moneymaker for The New York TimesHis arrival at 1600 Pennsylvania Avenue was itself something of a mystery. Some aides said he was discovered by Kayleigh McEnany, the White House press secretary. Others said John McEntee, the president’s personnel chief, had been Googling for a Trump-friendly doctor who would be loyal.Marc Short, Mr. Pence’s chief of staff, opposed hiring Dr. Atlas. But once the president and his team brought him in, Mr. Short insisted that Dr. Atlas have a seat at the task force table, hoping to avoid having him become yet another internal — and destructive — critic.Once inside, Dr. Atlas used the perch of a West Wing office to shape the response. During a meeting in early fall, Dr. Atlas asserted that college students were at no risk from the virus. We should let them go back to school, he said. It’s not a problem.Dr. Birx exploded. What aspect of the fact that you can be asymptomatic and still spread it do you not understand? she demanded. You might not die, but you can give it to somebody who can die from it. She was livid.“Your strategy is literally going to cost us lives,” she yelled at Dr. Atlas. She attacked Dr. Atlas’s ideas in daily emails she sent to senior officials. And she was mindful of a pact she had made with Dr. Hahn, Dr. Fauci and Dr. Redfield even before Dr. Atlas came on board: They would stick together if one of them was fired for doing what they considered the right thing.Health officials often had a hard time finding an audience in the upper reaches of the West Wing. In a mid-November task force meeting, they issued a dire warning to Mr. Meadows about the looming surge in cases set to devastate the country. Mr. Meadows demanded data to back up their claim.One outcome of the meeting was a Nov. 19 news conference on the virus’s dire threat, the first in many weeks. But while Mr. Pence, who led the briefing, often urged Americans to “do their part” to slow the spread of the virus, he never directly challenged Mr. Trump’s hesitancy on masks and social distancing. At the briefing, he said that “decision making at the local level” was key, continuing a long pattern of the administration seeking to push responsibility to the states.Mr. Azar had been cut out of key decision-making as early as February, when Mr. Pence took over the task force. Mr. Azar would complain to his associates that Mr. Pence’s staff and task force members went around him to issue orders to his subordinates.On tenterhooks about his job status, Mr. Azar found an opening that offered a kind of redemption, steering his attention through the summer and fall to Operation Warp Speed, the government’s effort to support rapid development of a vaccine, lavishing praise on Mr. Trump and crediting him for nearly every advance.Behind the scenes, Mr. Azar portrayed Dr. Hahn to the White House as a flailing manager — a complaint he also voiced about Dr. Redfield. In late September, he told the White House he was willing to fire Dr. Hahn, according to officials familiar with the offer.For their part, Dr. Hahn, Dr. Redfield, Dr. Birx and other senior health officials saw Mr. Azar as crushing the morale of the agencies he oversaw as he sought to escape blame for a worsening crisis and to strengthen his own image publicly and with the White House.Health officials on the task force several times took their complaints about Mr. Azar to Mr. Pence’s office, hoping for an intervention.Caitlin B. Oakley, a spokeswoman for Mr. Azar, said he had “always stood up for balanced, scientific, public health information and insisted that science and data drive the decisions.”Once eager to visit the White House, Dr. Hahn became disillusioned with what he saw as its efforts to politicize the work of the Food and Drug Administration, and he eventually shied away from task force meetings, fearing his statements there would leak.If there was a bureaucratic winner in this West Wing cage match, it was Dr. Atlas.He told Mr. Trump that the right way to think about the virus was how much “excess mortality” there was above what would have been expected without a pandemic.Mr. Trump seized on the idea, often telling aides that the real number of dead was no more than 10,000 people.As of Thursday, 342,577 Americans had died from the pandemic.Two coronavirus vaccines arrived at sites across the country this month. Mr. Trump was furious that a successful vaccine was not announced until after the election.Credit…Bryan Anselm for The New York TimesTrump vs. Vaccine RegulatorsIn an Oval Office meeting with senior health officials on Sept. 24, the president made explicit what he had long implied: He wanted a vaccine before the election, according to three people who witnessed his demand.Pfizer’s chief executive had been encouraging the belief that the company could deliver initial results by late October. But Mr. Trump’s aides tried in vain to make clear that they could not completely control the timing.Dr. Fauci and Dr. Hahn reminded West Wing officials that a company’s vaccine trial results were a “black box,” impossible to see until an independent monitoring board revealed them. A vaccine that did not go through the usual, rigorous government approval process would be a “Pyrrhic victory,” Mr. Azar told them. It would be a shot no one would take.Dr. Moncef Slaoui, the scientific leader of Operation Warp Speed, said the president never asked him to deliver a vaccine on a specific timetable. But he said Mr. Trump sometimes complained in meetings that “it was not going to happen before the election and it will be ‘Sleepy Joe’” who would ultimately get credit.In late October, science and regulations worked against Mr. Trump’s waning hopes for pre-Election Day good news. At the F.D.A., scientists had refined the standards for authorizing a vaccine for emergency use. And at Pfizer, executives realized that the agency was unlikely to authorize its vaccine on the basis of so few Covid-19 cases among its clinical trial volunteers.They decided to wait for more data, a delay of up to a week.When Pfizer announced on Nov. 9 — two days after Mr. Biden clinched his victory — that its vaccine was a stunning success, Mr. Trump was furious. He lashed out at the company, Dr. Hahn and the F.D.A., accusing “deep state regulators” of conspiring with Pfizer to slow approval until after the election.The president’s frustration with the pace of regulatory action would continue into December, as the F.D.A. went through a time-consuming process of evaluating Pfizer’s data and then that of a second vaccine maker, Moderna.On Dec. 11, Mr. Meadows exploded during a morning call with Dr. Hahn and Dr. Peter Marks, the agency’s top vaccine regulator. He accused Dr. Hahn of mismanagement and suggested he resign, then slammed down the phone. That night, the F.D.A. authorized the Pfizer vaccine.In the weeks that followed, Mr. Pence, Mr. Azar, Dr. Fauci and other health officials rolled up their sleeves to be vaccinated for the cameras.Mr. Trump, who after contracting Covid-19 had declared himself immune, has not announced plans to be vaccinated.Michael D. Shear More

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      ‘Like a Hand Grasping’: Trump Appointees Describe the Crushing of the C.D.C.

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      #masthead-section-label, #masthead-bar-one { display: none }The Coronavirus OutbreakliveLatest UpdatesMaps and CasesThe Latest Vaccine InformationU.S. Deaths Surpass 300,000F.A.Q.AdvertisementContinue reading the main storySupported byContinue reading the main story‘Like a Hand Grasping’: Trump Appointees Describe the Crushing of the C.D.C.Kyle McGowan, a former chief of staff at the Centers for Disease Control and Prevention, and his deputy, Amanda Campbell, go public on the Trump administration’s manipulation of the agency.“Every time that the science clashed with the messaging, messaging won,” said Kyle McGowan, a former chief of staff of the Centers for Disease Control and Prevention.Credit…Audra Melton for The New York TimesDec. 16, 2020Updated 9:36 a.m. ETATLANTA — Kyle McGowan, a former chief of staff at the Centers for Disease Control and Prevention, and his deputy, Amanda Campbell, were installed in 2018 as two of the youngest political appointees in the history of the world’s premier public health agency, young Republicans returning to their native Georgia to dream jobs.But what they witnessed during the coronavirus pandemic this year in the C.D.C.’s leadership suite on the 12-floor headquarters here shook them: Washington’s dismissal of science, the White House’s slow suffocation of the agency’s voice, the meddling in its messages and the siphoning of its budget.In a series of interviews, the pair has decided to go public with their disillusionment: what went wrong, and what they believe needs to be done as the agency girds for what could be a yearslong project of rebuilding its credibility externally while easing ill feelings and self-doubt internally.“Everyone wants to describe the day that the light switch flipped and the C.D.C. was sidelined. It didn’t happen that way,” Mr. McGowan said. “It was more of like a hand grasping something, and it slowly closes, closes, closes, closes until you realize that, middle of the summer, it has a complete grasp on everything at the C.D.C.”Last week, the editor in chief of the C.D.C.’s flagship weekly disease outbreak reports — once considered untouchable — told House Democrats investigating political interference in the agency’s work that she was ordered to destroy an email showing Trump appointees attempting to meddle with their publication.The same day, the outlines of the C.D.C.’s future took more shape when President-elect Joseph R. Biden Jr. announced a slate of health nominees, including Dr. Rochelle Walensky, the chief of infectious diseases at Massachusetts General Hospital, as the agency’s new director, a move generally greeted with enthusiasm by public health experts.“We are ready to combat this virus with science and facts,” she wrote on Twitter.Mr. McGowan and Ms. Campbell — who joined the C.D.C. in their early 30s, then left together in August — said that mantra was what was most needed after a brutal year that left the agency’s authority crippled.In November, Mr. McGowan held conversations with Biden transition officials reviewing the agency’s response to the pandemic, where he said he was candid about its failures. Among the initiatives he encouraged the new administration to plan for: reviving regular — if not daily — news briefings featuring the agency’s scientists.Mr. McGowan and Ms. Campbell, both 34, say they tried to protect their colleagues against political meddling from the White House and Department of Health and Human Services. But an agency created to protect the nation against a public health catastrophe like the coronavirus was largely stifled by the Trump administration.The White House insisted on reviewing — and often softening — the C.D.C.’s closely guarded coronavirus guidance documents, the most prominent public expression of its latest research and scientific consensus on the spread of the virus. The documents were vetted not only by the White House’s coronavirus task force but by what felt to the agency’s employees like an endless loop of political appointees across Washington.Mr. McGowan recalled a White House fixated on the economic implications of public health. He and Dr. Robert R. Redfield, the C.D.C. director, negotiated with Russell T. Vought, the White House budget director, over social distancing guidelines for restaurants, as Mr. Vought argued that specific spacing recommendations would be too onerous for businesses to enforce.“It is not the C.D.C.’s role to determine the economic viability of a guidance document,” Mr. McGowan said.They compromised anyway, recommending social distancing without a reference to the typical six-foot measurement.One of Ms. Campbell’s responsibilities was helping secure approval for the agency’s Morbidity and Mortality Weekly Reports, a widely followed and otherwise apolitical guide on infectious disease renowned in the medical community. Over the summer, political appointees at the health department repeatedly asked C.D.C. officials to revise, delay and even scuttle drafts they thought could be viewed, by implication, as criticism of President Trump.“It wasn’t until something was in the M.M.W.R. that was in contradiction to what message the White House and H.H.S. were trying to put forward that they became scrutinized,” Ms. Campbell said.Dr. Tom Frieden, the C.D.C. director under President Barack Obama, said it was typical and “legitimate” to have interagency process for review.“What’s not legitimate is to overrule science,” he said.Often, Mr. McGowan and Ms. Campbell mediated between Dr. Redfield and agency scientists when the White House’s requests and dictates would arrive: edits from Mr. Vought and Kellyanne Conway, the former White House adviser, on choirs and communion in faith communities, or suggestions from Ivanka Trump, the president’s daughter and aide, on schools.“Every time that the science clashed with the messaging, messaging won,” Mr. McGowan said.Episodes of meddling sometimes turned absurd, they said. In the spring, the C.D.C. published an app that allowed Americans to screen themselves for symptoms of Covid-19. But the Trump administration decided to develop a similar tool with Apple. White House officials then demanded that the C.D.C. wipe its app off its website, Mr. McGowan said.Ms. Campbell said that at the pandemic’s outset, she was confident the agency had the best scientists in the world at its disposal, “just like we had in the past.”“What was so different, though, was the political involvement, not only from H.H.S. but then the White House, ultimately, that in so many ways hampered what our scientists were able to do,” she said.Top C.D.C. officials devised workarounds. Instead of posting new guidance for schools and election officials in the spring, they published “updates” to previous guidance that skipped formal review from Washington. That prompted officials in Washington to insist on reviewing updates.Brian Morgenstern, a White House spokesman, said that “all proposed guidelines and regulations with potentially sweeping effects on our economy, society and constitutional freedoms receive appropriate consultation from all stakeholders, including task force doctors, other experts and administration leaders.”A C.D.C. spokesman declined to comment.Mr. McGowan and Ms. Campbell both attended the University of Georgia and saw their C.D.C. positions as homecomings. Mr. McGowan said the two institutions he revered most during his Georgia childhood were the C.D.C. and Coca-Cola.He arrived with a résumé that made the agency’s senior ranks suspicious, he said. Like Ms. Campbell, he worked for former Representative Tom Price, first in his House office, then when he was health secretary under Mr. Trump. When he arrived at the C.D.C., Mr. McGowan told his new colleagues that he was there not to spy on or undermine them, but to support them.Mr. McGowan and Ms. Campbell, who have since opened a health policy consulting firm, said they saw themselves as keepers of the agency’s senior scientists, whose morale had been sapped. Dr. Redfield, whose leadership has been criticized roundly by public health experts and privately by his own scientists, was rarely in Atlanta, consumed by Washington responsibilities.The Coronavirus Outbreak More

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      The Biden Opportunity and How to Blow It

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      AdvertisementContinue reading the main storyOpinionSupported byContinue reading the main storyThe Biden Opportunity and How to Blow ItThe president-elect won promising conciliation. His choice of Xavier Becerra to run Health and Human Services promises culture war.By More