May 17, 2020 - Politics & Policy

Why Deborah Birx is the real power doctor

Photo illustration of Deborah Birx and The White House

Photo Illustration: Eniola Odetunde/Axios. Photo: Pool/Getty Images

Don't be fooled by the grandmotherly demeanor and whimsical scarf collection. Administration officials say they've been taken aback by Deborah Birx's masterful political skills — including a preternatural ability to get what she wants while telling people what they want to hear.

Why it matters: She's better than any of the other public health officials at talking to Trump. While MAGA-land has spent weeks trying to get Anthony Fauci fired, Birx has been far more adept at influencing the president and shaping the administration's response to the global coronavirus pandemic.

Behind the scenes: Senior officials said a conversation in the Situation Room several weeks ago crystallized the differences between the White House's top two doctors.

  • On Good Friday, President Trump polled the doctors about the World Health Organization. In that meeting, he pressed Birx, Fauci and CDC director Robert Redfield for their thoughts on the troubled institution.
  • The question was a loaded one. The officials in the room were well-aware that Trump was considering taking severe action against the global health agency, which he says is controlled by China.
  • The Tuesday after the meeting, Trump announced a freeze on U.S. funding of the WHO, pending an investigation into the health agency and its coronavirus response.

In the Situation Room, Birx was very critical of the WHO and its relationship with China. She said the institution badly needed reform, according to two sources in the room. In subsequent TV appearances, however, she sang a different tune. She was far less harsh about the WHO than behind closed doors, according to one official.

  • Fauci was more ambivalent in the Situation Room meeting. He started out by saying the WHO is an imperfect organization, but he also praised its director-general, Tedros Adhanom Ghebreyesus.
  • Fauci said Tedros is a good guy and he's known him a long time. The president intervened to ask, but how are they on China? Fauci replied, "The WHO director has a China problem," according to a source in the room.
  • Another source who was in the room recalled the president responded by saying something to the effect of: "Tony, you're burying the lede here! Come on, Tony!" "Then the whole room laughed," the source said. "At that point, there was a unanimous view that the WHO listens to China too much."

Between the lines: The episode highlights the starkly different approaches Birx and Fauci have taken to wielding influence in the Trump White House. Fauci speaks his mind with little if any considerations of politics. Colleagues say Birx strategically emphasizes the points Trump wants to hear — and she can play multiple angles on any given issue.

  • Birx is far from a folk hero. Her public praise of the president has drawn her criticism from the left as a brown-noser and a hack. One veteran official, however, described her as a consummate D.C. operator.
  • For instance, Birx has spoken warmly about her decades-long working relationship with Redfield and praised the CDC. On the other hand, she recently excoriated the quality of the CDC's data in front of the task force. That message, which soon leaked to the media, resonated strongly with Trump, who is irritated by the CDC.
  • Officials credit Birx for playing an important role in convincing Trump in late March to buck his instincts and extend social distancing guidelines by 30 days. (But he soon undermined that advice by encouraging protesters to "liberate" themselves from their governors' rules.)
  • "The media is clearly enamored with Fauci, but Dr. Birx is significantly more influential in the West Wing," says one senior White House official. "It's influence not just because she's an operator — she's also a workhorse. She's the person building the models and poring over the data every night to brief POTUS and the task force."

The big picture: Officials say the #FireFauci movement is a waste of time. Trump nods along when Fauci talks, but the idea that he's being guided by Fauci is absurd. He's listened to Fauci on some matters — for instance, Fauci was very aggressive in telling Trump not to pursue a herd immunity strategy like the United Kingdom — but on many other issues, Trump has ignored his advice.

  • Trump has publicly contradicted Fauci's assessments of America's testing capabilities.
  • And last week, he said Fauci had not given an "acceptable answer" in his Senate testimony when he raised concerns about reopening schools.
  • Trump also repeatedly contradicted Fauci on the merits of the drug hydroxychloroquine.
  • Trump has privately joked about how Fauci is "friends with Fredo," (Trump's nickname for CNN anchor Chris Cuomo) and he's publicly joked about how Fauci could win a primary against AOC.
  • "They seem to have a great relationship, they joke around," a senior administration official said. The official said that in a Situation Room meeting, Trump joked that Fauci depresses people while he gives them hope, and that they could take the show on the road. Trump then told Fauci he loved him, "and Tony said, 'I love you too, Mr. President,'" the official said.

The bottom line: Trump has made clear to advisers that he doesn't want to give a daily platform to public health warnings that could discourage an economic reopening.

  • But when Birx picks a battle — as she did privately against Georgia's decision to open tattoo parlors and hair salons — Trump listens.
  • He criticized Georgia Gov. Brian Kemp, but later encouraged aggressive reopenings across the country.
Go deeper