The following is a transcript of an interview with former White House coronavirus response coordinator Dr. Deborah Birx that aired Sunday, January 24, 2021, on "Face the Nation."
The extended interview can be found, and heard as a special edition episode of the new podcast.
MARGARET BRENNAN: Dr. Deborah Birx, the former White House Coronavirus Response Coordinator, is now at the CDC as a special advisor to the Center for Global Health. We sat down with her Friday--she had wanted to wait until after President Biden had taken office to talk about her time in the Trump administration.
MARGARET BRENNAN: The Biden coronavirus czar, for lack of a better term, told reporters, "When it comes to the vaccine, what we're inheriting is so much worse than we could have imagined." Is that a political statement? Is that accurate?
DR. BIRX: You know, I've been trying to process all the last 11 months because I- it's really important that we understand what worked and what didn't work. I took extensive notes during the entire process because I didn't want to lose track of what we need to do to make our response better in the future. One of those critical areas is this idea of federalism on which the United States was built. But that can be taken to extremes. And so the mantra always was federally supported and state-managed, locally executed.
MARGARET BRENNAN: That was the Trump plan?
DR. BIRX: That was the mantra. But what does support mean? And what does federal support mean? And I think really an understanding of what states need to translate guidance into implementation, what state needs- states need in interpreting data together. They only are seeing their data. But it's really important that they understand what's happening in their entire region because people have been mobile.
MARGARET BRENNAN: Do you think it's just bad architecture being handed off to the Biden administration? Are they being set up for failure?
DR. BIRX: Oh, I don't believe- and I- I- if I thought that was true, I wouldn't be sleeping right now because what was very important to me is from even before the election is to make sure that people had access to data and the data that we were seeing. And I think the more people can understand where the virus is, where it's increasing, where it's decreasing and react to even the slightest uptick. And that's a place where we're still slow.
MARGARET BRENNAN: Surveillance?
DR. BIRX: We're still slow in reaction. You need to react when you first see that tiniest little uptick in test positivity. That's the moment to tell that population. We need you to do these things.
MARGARET BRENNAN: You were often at odds with the CDC, is what I've been told. Is that true?
DR. BIRX: I know the CDC well, so it was diff- let me just be very clear, it was more difficult for them because I knew where the gaps were. And so when I came in, I really asked for those gaps to be addressed. I was also very pushy, and the one thing that's been taken completely out of context is when I was talking about not trusting the CDC data, it had to do with the ethnicity and race of the fatalities early on because of the delay in that reporting our delay for death certificates that have all that information on can be up to 30 days.
MARGARET BRENNAN: So, we're at the end of February. CDC official gives a briefing to reporters that tanks the markets when she says that within the community there may be a virus spreading and it could cause severe disruption to daily life. Dr. Fauci goes on television a few days later and says the risk to Americans remains low. You're watching this and what are you thinking?
DR. BIRX: So I'm in South Africa. we're yelling at the CNN television saying this is going to be a pandemic because the Chinese- what I saw from China, when you overwhelm your hospitals, you have to know that you have broad-based community spread before that happens. Yet they weren't seeing it. And that really worried me because what we were looking for is people with symptoms. And so when people were coming into the country, we were looking for people with symptoms.
MARGARET BRENNAN: But why wasn't it obvious to them, when you're watching this on TV and saying this is so clearly a pandemic that's coming to hit us hard?
DR. BIRX: I've learned from the things we've missed. This is exactly how we missed the HIV pandemic. If you're only looking for sick people, you miss a lot of the- what is really happening under the surface. And so I was always worried that there was a big iceberg under the surface and we were just seeing the top of it. So, when we were questioning people who came into this country about symptoms rather than testing everybody who came into the country, that's when I started to get really worried. At the same time there was a single individual in the White House that had been calling me since January.
MARGARET BRENNAN: That was Matt Pottinger,--
DR. BIRX: Yes.
MARGARET BRENNAN: --the Deputy National Security Adviser?
DR. BIRX: Because I have- I've known him and I've known his wife for a very long time. We've worked on pandemics together. Both of us were in Asia during SARS. And so we understood how serious this can go
MARGARET BRENNAN: Matt Pottinger asks you to come from the State Department to the White House.
DR. BIRX: And I said no about 20 times.
MARGARET BRENNAN: Why?
DR. BIRX: Well, from the outside, everything looks very chaotic in the White House. I had spent--
MARGARET BRENNAN: Wasn't it?
DR. BIRX: --the first three years of this administration trying to stay out of the swirl, trying to protect the PEPFAR program. We had extraordinary cuts, obviously, every year.
MARGARET BRENNAN: This is AIDS?
DR. BIRX: The President's Emergency Plan for AIDS Relief. It's what's changed the trajectory of the pandemic around the world, both for HIV and TB. I had no interest in going into a political space. I'm not a political person. I'm a civil servant. It never occurred to me to go into the White House until I could see that we were missing pieces that I thought were very important in the response. And so after many weeks of saying, no, no, no, the president announced the new task force with the vice president in the lead. They said this would be very technical, and that I would have a very technical position. And because I thought that I could be helpful, which is the only reason I go and do anything. If I think I have something to add, I feel like it's my obligation to the American public to go in and do that. That's what a civil servant is supposed to do.
MARGARET BRENNAN: You were a colonel in the Army?
DR. BIRX: Yes.
MARGARET BRENNAN: An immunologist, you were appointed by President Obama to work on AIDS relief, as you mentioned, at the State Department. Yet your name in the history books is going to be associated with President Donald Trump. How does that sit with you?
DR. BIRX: Well, you know, this is what worries me. If we start looking at technical civil servants as belonging to a political party, we will lose the ability for highly qualified civil servants to come and help. If we start saying if you come in and do this, you are then going to be part of the political apparatus, that is going to be very dangerous for this country.
MARGARET BRENNAN: Do you feel like your work is misunderstood as political?
DR. BIRX: I think pandemics are always political. That's what, I mean, I've worked in 60 countries. Every pandemic is political because you have to make policy changes to confront them, and policies are often political.
MARGARET BRENNAN: You worked on AIDS, which is a highly politicized virus--
DR. BIRX: Correct.
MARGARET BRENNAN: --in sub-Saharan Africa. But did any of that prepare you for the politics you encountered here with this pandemic in this White House?
DR. BIRX: No. No. White Houses function in a pretty- a pretty bureaucratic way, and most of the agencies function in a very predictable and bureaucratic way. But when you remove the infrastructure of the civil servants, then you end up with a lot more very quick right turns, left, turns, right turns, left turns, and that- that becomes less predictable and less able to manage that kind of response and change. And so that's why I kept extensive notes from every meeting, daily reflections to really understand what I was seeing. I wrote a daily report, over 310 of them that went to senior leaders. We created--
MARGARET BRENNAN: Did President Trump read them?
DR. BIRX: I don't know. I don't know. I sent them up through to the vice president. I had very little exposure to--
MARGARET BRENNAN: But you did brief President Trump?
DR. BIRX: I had very little exposure to President Trump.
MARGARET BRENNAN: Do you think President Trump appreciated the gravity of the health crisis you were describing?
DR. BIRX: I think the president appreciated the gravity in March. It took a while after I arrived in the White House to remove all of the ancillary data that was coming in. I mean, there was parallel data stream coming into the White House that were not transparently utilized. And I needed to stop that where people were--
MARGARET BRENNAN: You mean outside advisors?
DR. BIRX: Outside advisers, coming to inside advisors. And to this day, I mean, until the day I left, I am convinced there were parallel data streams because I--
MARGARET BRENNAN: Disinformation?
DR. BIRX: I saw the president presenting graphs that I never made. So, I know that someone- or someone out there or someone inside was creating a parallel set of data and graphics that were shown to the president. I know what I sent up and I know that what was in his hands was different from that. You can't do that. You have to use the entire database--
MARGARET BRENNAN: Who was doing that?
DR. BIRX: To this day I don't know. I know now by watching some of the tapes that certainly Scott Atlas brought in parallel data streams. I don't know who else was part of it, but I think when the record goes back and people see what I was writing on a daily basis that was sent up to White House leadership, that they will see that- that I was highly specific on what I was seeing and what needed to be done.
MARGARET BRENNAN: So the chief of staff is not saying, wait a second, this is our official coordinator listen to her and her only? Listen to you? No one was saying that?
DR. BIRX: No one said that to me.
MARGARET BRENNAN: To the president?
DR. BIRX: I- I don't know if they were saying it to the president.
MARGARET BRENNAN: Welcome back to FACE THE NATION. We continue our conversation with Dr. Birx.
MARGARET BRENNAN: Do you think the president was just distracted by the political implications and the campaign?
DR. BIRX: You know, I always wonder that, and, I mean, the worst possible time you can have a pandemic is in a presidential election year. I think the White House personnel were very focused on this pandemic in March and April. I think once the country began to open and it was clear to me that they weren't going to follow my really gated criteria that I had worked hard on.
MARGARET BRENNAN: How to open restaurants, how to let people dine indoors--
DR. BIRX: I combined all of that together for these great gating criteria. So in calculating everything with the slow reopening, I didn't think anyone could get to Phase 3 until August. And you can see in the states that followed either that criteria or similar criteria, that's how long it took them.
MARGARET BRENNAN: Were there COVID deniers in the White House?
DR. BIRX: There are people in the White House and I think people around this country, because I've had the privilege to meet them and listen to them and hear them, because I wanted to hear what people were saying. There were people who definitely believed that this was a hoax.
MARGARET BRENNAN: Why?
DR. BIRX: I think because the information was confusing at the beginning. I think because we didn't talk about the spectrum of disease, because everyone interpreted on what they knew. And so they saw people get COVID and be fine.
MARGARET BRENNAN: So you don't blame the president's own language of calling some of this politically motivated, a hoax? It was a phrase he used at one point.
DR. BIRX: When you have a pandemic where you're relying on every American to change their behavior, communication is absolutely key. And so every time a- a statement was made by a political leader that wasn't consistent with public health needs, that derailed our response. It is also why I went out on the road because I wasn't censored on the road.
MARGARET BRENNAN: You felt the White House was censoring you?
DR. BIRX: Well, if you noticed, I was not able to do national press. The other thing that was very important to me is I was not going to go outside of the chain of command. And so if our White House comms group did not put me out, I didn't ask to go out. I- because there was so much leaking and so many parallel stories being leaked to the press that did not have grounding in truth that I didn't want to ever be part of that slippery slope. I know people started it with good intentions of trying to inform the American people, but then it became a way that they could silence those who didn't agree with them. And so I knew that every time I had a significant disagreement in the White House that within days a story would be planted.
MARGARET BRENNAN: Who was doing that?
DR. BIRX: I think a lot of people were doing that.
MARGARET BRENNAN: Do you think the administration was suppressing vital information to win the election?
DR. BIRX: I don't know what their motivation was. I know that I was so frustrated that I realized that the only way, if I could not get a voice internally, that I could get a voice out at the state level because I could see the governors on the governor's call weekly and I could see how deeply they were concerned about every one of their citizens. Most of them were not in the middle of an election campaign. I want to make it clear this was just not Debbie Birx. There was a coalition of- of four of us at the beginning, from Steve Hahn to Bob Redfield to myself to Tony Fauci. We would make sure that we could get the information out to the public in one way or the other. It's why I sent the information to all of them every morning, because I never knew who would have the ability to do press.
MARGARET BRENNAN: Did you ever consider quitting?
DR. BIRX: Always.
DR. BIRX: I mean, why would you want to put yourself through that, um- every day? Colleagues of mine that I had known for decades- decades in that one experience, because I was in the White House decided that I had become this political person, even though they had known me forever. I had to ask myself every morning is there something that I think I can do that would be helpful in responding to this pandemic? And it's something I asked myself every night. And when it became a point where I could- I wasn't getting anywhere and that was like right before the election, I wrote a very detailed communication plan of what needed to happen the day after the election and how that needed to be executed. And there was a lot of promise that that would happen.
MARGARET BRENNAN: Because you knew at that point that the election was a factor in communication about the virus?
DR. BIRX: Yes. Yes.
MARGARET BRENNAN: Did you ever withhold information yourself?
DR. BIRX: No.
MARGARET BRENNAN: Some people felt you became an apologist for President Trump. They look at that moment in the briefing room
PRESIDENT DONALD TRUMP: Then I see the disinfectant which knocks it out in a minute. And is there a way you can do something like that by injection inside or almost a cleaning?
MARGARET BRENNAN: You were sitting there and he looked at you and he asked about ultraviolet light and heat--
DR. BIRX: See, that,--
MARGARET BRENNAN: --and you start talking about fevers. You didn't say no.
DR. BIRX: No, no.
PRESIDENT DONALD TRUMP: Deborah have you ever heard of that? The heat and the light relative to certain viruses, yes, but relative to this virus?
DR. BIRX: Not as a treatment.
DR. BIRX: He was not speaking to me. He was speaking to the DHS scientist that was two seats over from me that entire time. When he finally turned to me and said, is it a- could this be a treatment, I said, not a treatment. You can look at the transcripts. Not a treatment.
DR. BIRX: But that moment was- that was completely lost. And then there's, you know, skits on Saturday Night Live.
SATURDAY NIGHT LIVE CLIP: "DR. BIRX": We all mess up sometime. You threw the ball wrong. I didn't say 'don't drink the bleach' It happens!
Dr. BIRX: When you're a scientist who's grounded themselves in data and combating epidemics and working with communities and working with governments to change the future of people's lives for the better and then you get- this is what- when you talked about, was I prepared for that? No, I wasn't prepared for that. I didn't even know what to do in that moment.
MARGARET BRENNAN: Sometimes people say, well, Tony Fauci, when that happened to- to him, he would sort of gently come back up to the podium and set the record straight.
DR. BIRX: Well, he was given the opportunity to do that, though.
MARGARET BRENNAN: And you don't feel- you don't feel you were given the opportunity to respond?
DR. BIRX: Not until he turned to me and said, could this be a treatment? And I said, not a treatment. You know, people then want to define you by the moment and I understand- I, look, I understand how perceptions go. I understood that to go into the White House and try to support a comprehensive coronavirus response by utilizing the strength of the federal government would be a terminal event for my federal career, which is part of the reason why I didn't want to do it.
MARGARET BRENNAN: A terminal event?
DR. BIRX: A terminal event. I know that I wouldn't be allowed to really continue successfully within the federal government. You can't go into something that's that polarized and not believe that you won't be tainted by that experience or how people interpret you in that experience. So I knew that part of it. I didn't want that to happen.
MARGARET BRENNAN: And this will be the end of your federal career?
DR. BIRX: Yeah, I will need to retire probably within the next four to six weeks from CDC.
MARGARET BRENNAN: And how have you made peace with that, that this pandemic, that you're leaving in the midst of this, that you will be associated with it?
DR. BIRX: What was reassuring to me all along is I knew this would be studied. I knew that the emails, the reports that I wrote, the request to expand testing, the how to improve therapeutics, all of that, all of that would eventually come to light. Maybe not in my lifetime.
MARGARET BRENNAN: You feel you'll be vindicated?
DR. BIRX: I'm not looking to be vindicated. In that moment I think my service was important. I think it was important to make progress in testing. I think it was important in making progress with some of the therapeutics. And I think it was important to really- we had great innovation in vaccines. I was focused solely on the mission, and the mission was to try to save as many American lives during this pandemic as possible. And so I couldn't get distracted on vindicating myself or getting the information or telling the, you know, coming back to the press and saying that's not what happened. That would waste my energy in that moment of staying focused completely on that data and ensuring that I was seeing everything that was going on.
MARGARET BRENNAN: I read a Washington Post profile of you and it said, "When she's working on a vital public health issue, Birx will do whatever is necessary as long as she thinks she can make a difference."
DR. BIRX: True. And it hurt my family. You know, all of this- I have two daughters in their 30s who had to live through this and watch their mother, these things said about their mother, to become a skit, I mean. I have two grandchildren, daughters. You know, I think, I felt the whole time that I also had to be serious to be taken seriously, and I couldn't ever let emotion come into this, that no matter how frustrated I got, no matter how beaten down I got, I had to keep pushing as hard as I could. This tested my resilience because it tested my family and the things that were said that were so untrue, all of that about Thanksgiving.
MARGARET BRENNAN: You were accused of gathering with people outside your household because you went to a beach house with them?
DR. BIRX: There was no one outside of my household. I have one household. We happen to live between two houses because I had to protect them from me when I was out on the road. When I came back I quarantined. But if I had an emergency at that house, I wore a mask the whole time because I had to protect that household at all costs. I have a 92-year-old mother and a 96-year-old father and a- a daughter that's 38 weeks pregnant. And so the implication that I wouldn't follow CDC guidance- I followed CDC guidance and that's what protected me. I mean, I was on the road for six and a half months. I was in the White House during the hot- one of the hottest hot spots of viral transmission and I remained negative because I followed the CDC guidelines. That's why I know they work and that's why I take it very seriously.
MARGARET BRENNAN: Well, this summer, you gave an interview.
BIRX ON CNN: "What we are seeing today is different from March and April. It is extraordinarily widespread.
MARGARET: And then President Trump tweeted. He blasted you for saying that. Did you ever speak to him after that?
DR. BIRX: I hadn't seen him for months before that or months after that, but that was like--
MARGARET BRENNAN: You're the coordinator of the COVID Task Force.
DR. BIRX: --that was a- that was an extraordinary moment because I also got yelled out by the speaker, who I have tremendous I mean, obviously,--
MARGARET BRENNAN: Speaker Pelosi?
DR. BIRX: --women have gone through a lot to get in their positions. I have tremendous respect for women and women leadership.
MARGARET BRENNAN: Speaker Pelosi said she didn't have confidence in you because you were working for President Trump.
SPEAKER PELOSI ON CNN: I don't have confidence in anyone who stands there while the president says, 'swallow lysol, and it's going to cure your virus.' You know, it will kill you, and you won't have the virus anymore.
DR. BIRX: And so that was very hard because I have known her from the HIV world, and I have tremendous respect for what she brought early on. So in my mind, she's a political hero for what she has done in HIV, which, you know, I've spent a lifetime on, along with TB--
MARGARET BRENNAN: So that stung?
DR. BIRX: Oh, that was hard. But she's not the only one, I think she gave voice to what a lot of people were thinking of, how could you? I think they looked at going into the White House as somehow supporting a political party or a political individual. There are technical people that are brought in for their technical expertise.
MARGARET BRENNAN: But you often were perceived as explaining some of the things President Trump said rather than correcting him.
DR. BIRX: Well, when people asked me a question, I feel like I have to respond with what my perception of that moment was.
MARGARET BRENNAN: When we come back, Dr. Birx talks about masks, or the lack thereof, in the White House.
MARGARET BRENNAN: We want to pick back up with Dr. Birx, talking about the moment last spring when she and the task force realized that they had a serious problem.
DR. BIRX: Everyone knew that. Everyone knew that from, I would say, March- March 8th on. Because you only had to look at the slopes of the curves in these major metropolitan cities to understand what was happening and understanding if you're seeing that rate of hospitalization, how much community spread there was.
MARGARET BRENNAN: But you were trying to get Americans just to wear masks. And the president himself was undermining you. He wasn't wearing one. Is there ever a way to make that scenario work?
DR. BIRX: Well, you have to, because that's the president. So you have to figure out how to get that message out when you can't get it out from the head of the country. And that's our job. You don't give up. You can't ever in any moment when American lives are at stake, say, well, this is just too hard. I'm giving up.
MARGARET BRENNAN: But where's the vice president in all of this?
DR. BIRX: The vice president knew what I was doing.
MARGARET BRENNAN: You mean he knew that you were telling the governors privately to do things that the president publicly was making light of. When he was saying you don't really need to wear a mask, or pushing to reopen the economy faster than your guidelines would allow, Mike Pence knew that?
DR. BIRX: He knew what I was doing because--
MARGARET BRENNAN: And he supported it?
DR. BIRX: --I don't- I'm not a person who would go out on their own and not do, you know, I wouldn't go--
MARGARET BRENNAN: Why would you have to be sneaking around? You're the head of the COVID Task Force and tens of thousands of Americans are dying. Why is that a covert operation?
DR. BIRX: Because if this isn't working and you're not going to get that to work, you have to find another solution.
MARGARET BRENNAN: Leaving it up to the states, is that the way it should be in a pandemic, is the fundamental question?
DR. BIRX: Yes.
MARGARET BRENNAN: Tell me about some of the resistance from governors, because you're going out there and you're telling them to wear a mask, to limit indoor dining. And for some of these Republican governors, that would mean going against the head of their party to do what you're telling them to do.
DR. BIRX: You know, I don't know if that was as much as the dynamic as they were dealing with Republican legislatures and legislators. You needed every single level of government then to work together to ensure that, again, we're talking about behavioral change of American citizens.
MARGARET BRENNAN: How much responsibility lies on the shoulders of the governors running these states?
DR. BIRX: A lot. A lot. We have to be consistent. Sturgis was not okay. Birthday parties, not okay. Bringing together family members indoors, maskless, none of this. We have to be very clear to the community. And yes, we're going to make mistakes. We all make mistakes, we're human. If you made a mistake, if you had a gathering, at least get tested, wear a mask around those vulnerable, assume you got exposed and are infected and wear a mask around those vulnerable.
MARGARET BRENNAN: But how did the task force allow the president, who calls himself germaphobe, to get COVID himself? How did that happen?
DR. BIRX: There were only two people who regularly wore a mask in the White House.
MARGARET BRENNAN: Two people?
DR. BIRX: Myself and Tyler Ann McGuffee, the support person that I had from HHS.
MARGARET BRENNAN: So the staff around the president was not wearing a mask?
(BIRX SHAKES HER HEAD NO)
MARGARET BRENNAN: He's the commander in chief. This is a national security risk. How is that possible?
DR. BIRX: I think people believed testing- testing would be adequate.
MARGARET BRENNAN: So how is that possible?
DR. BIRX: I think they believe that testing is a surrogate for a public health intervention.
MARGARET BRENNAN: But did you say, "The President of The United States needs to wear a mask." Did you press Mike Pence on that? Did you press Mark Meadows, his chief of staff?
DR. BIRX: There are multiple communications about masking. Remember when I was talking about the stream of data coming in? They were mixing data that didn't have anything to do with the relevance of masking as a public health measure to changing into masking as a personal protective measure.
MARGARET BRENNAN: But did you ever say you're misunderstanding this? You need to wear a mask. These are close quarters and you're way too close to the President of the United States? You're nodding, yes, you had that argument?
DR. BIRX: Not with the president, I mean, I- I didn't have that kind of access, but to certainly people around the president. Yes.
MARGARET BRENNAN: And they just didn't take it seriously?
DR. BIRX: I just want to make it clear people were concerned about the president and wanted to protect the president. They believed that testing would be a reasonable substitution for people masking.
MARGARET BRENNAN: How sick did the president actually get?
DR. BIRX: I don't know. I don't know.
MARGARET BRENNAN: Did anyone ever say this is a national security risk and we need to nail down who brought this in and who infected the commander in chief?
DR. BIRX: I never heard those conversations.
MARGARET BRENNAN: There was no serious contact tracing that happened after the fact?
DR. BIRX: I don't know if there was contact tracing or not.
MARGARET BRENNAN: What was your biggest mistake?
DR. BIRX: I always feel like I could have done more, been more outspoken, maybe been more outspoken publicly- publicly. I didn't know all the consequences of all of these issues. When you're put into a new situation and you only know one person in the White House, you know, and you don't understand the culture of the White House, it's very difficult to get your footing. I'm not making excuses. I'm just saying I didn't know how far I could push the envelope.
MARGARET BRENNAN: You wish you pushed harder?
DR. BIRX: Yes.
MARGARET BRENNAN: We spent nearly 90 minutes talking to Dr. Birx. We'd been tested, and we were seated ten feet apart in a well ventilated facility. An extended version is available through our digital network, and in a special edition of our new podcast, FACING FORWARD.