The rapport between President Trump and top public health officials has been contentious for months. One relationship in particular that has been fraught with tension is the one between the president and Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, who has been in his position since 1984 and helped the country get through the HIV/AIDS epidemic, Ebola, Swine flu and Zika. During the coronavirus pandemic, Dr. Fauci’s advice has often been at odds with the President’s.
The strain seems to have finally boiled over yesterday when at a rally in South Florida, the crowd was chanting, “Fire Fauci! Fire Fauci!” The President responded by say, “Don’t tell anybody, but let me wait until a little bit after the election. I appreciate the advice.” These comments have left many concerned over this, possibly happening.
Delving into the legality of the issue, the president can’t directly fire Dr. Fauci because he isn’t a political appointee. He is a career federal employee, so he’s protected by federal civil service regulations that shield individuals from being fired or demoted for political reasons. In order to be removed, the agency would need to provide evidence that there is just cause for dismissal, such as misconduct or failure to follow orders. There has been some concern about these protections in recent weeks because Trump issued a controversial executive order that could remove them, which would make it easier to dismiss tens of thousands of civil servants with little cause or recourse.
For Dr. Fauci to be removed, the process would have to be initiated by someone in his chain of command, like the director of the National Institutes of Health or the health and human services secretary. Given his esteem in the scientific and medical communities, this is highly unlikely. If for some reason, this actually occurred, Dr. Fauci would be notified of the allegation and have the opportunity to respond via the Merit Systems Protection Board and, if necessary, appeal their decision in court.
Dr. Fauci isn’t the only public health official to disagree with Trump. Dr. Deborah Brix, the White House coronavirus task force coordinator, issued a recent report that contradicts the president’s notion that we’re “rounding the turn” on the pandemic. She warns against having large gatherings, encourages mask-wearing, and says testing is “flat or declining” in many areas where the number of cases is rising.
This is the exact opposite of what the President is saying and doing. He doesn’t wear a mask and makes fun of those who do. He has had several large gatherings at the White House and continues to hold multiple campaign rallies with thousands of people, and often people don’t wear masks at these events. He blames the rise in cases on more testing being done. Trump is taking advice from his new medical advisor, Dr. Scott Atlas, a neuroradiologist who has no infectious-disease experience. Dr. Atlas’ recommendation is to encourage herd immunity by allowing healthy people to resume daily activities without restrictions. Public health experts warn that to achieve herd immunity without a vaccine would cost thousands, if not millions, of lives.
In the report, Dr. Birx states, “We are entering the most concerning and most deadly phase of this pandemic … leading to increasing mortality. This is not about lockdowns — it hasn’t been about lockdowns since March or April. It’s about an aggressive balanced approach that is not being implemented.” This sentiment has been echoed by numerous public health officials across the country, including Dr. Fauci. Many of these individuals hope to raise awareness of the risk the pandemic could take thousands more lives as the weather worsens and we head into the holiday season unless people alter their behavior. Dr. Birx’s messaging has become increasingly dire in the past few weeks but seems to be ignored.
According to the report, “Cases are rapidly rising in nearly 30 percent of all USA counties, the highest number of county hotspots we have seen with this pandemic. Half of the United States is in the red or orange zone for cases despite flat or declining testing.” The data shows that it’s not just adults seeing a rise in cases but children as well. In the last week of October, there were 61,000 new cases in children.
The American Academy of Pediatrics (AAP) says this “is larger than any previous week in the pandemic.” Since the beginning of the pandemic through October 29th, 853,000 children have tested positive for the virus, with almost 200,000 of those coming last month alone. The organization says that these numbers are probably an undercount since children’s symptoms are usually mild and mimic common colds, which is why many children aren’t tested.
Thankfully, the number of cases of severe illness caused by the virus are rare in children. Most of these cases were seen in children with underlying health conditions with chronic lung diseases, like asthma, being the most likely culprit. One factor still unknown is the long-term impacts the disease has on the children infected by it.