Atlas push to 'slow the testing down' tracks with dramatic decline in one key state
Posted October 29, 2020 6:06 a.m. EDT
CNN — Shortly after joining the White House as President Donald Trump's pandemic adviser, Dr. Scott Atlas launched a quiet effort that seemed counterintuitive to some of his colleagues -- encouraging officials to limit Covid-19 testing mainly to people experiencing symptoms.
Atlas, a neuroradiologist, not an infectious disease expert, strongly supported a decision in August to revise federal guidelines to de-emphasize the need to test people without symptoms, according to two sources familiar with the process. He shared his view with state officials, including Republican Gov. Ron DeSantis and several others in Florida, according to transcripts of public events and accounts from private meetings in that state.
During a joint tour on August 31, Atlas and DeSantis urged public health officials in several Florida cities to focus less on universal testing and more on opening the economy and schools. In private and public meetings, according to transcripts and personal accounts, the two spoke in favor of testing people for Covid-19 primarily if they're experiencing symptoms, a controversial view among epidemiologists.
"The purpose of testing is to stop people from dying," Atlas said during one stop, captured on video. "When you start introducing closure of schools because people have positive, asymptomatic tests, that's sort of not the purpose of testing."
"I think, Dr. Atlas, we're in agreement on focusing strategies in school on people who are symptomatic," DeSantis said in another joint news conference that day.
Their push to de-emphasize tests coincided with a dramatic drop in testing across Florida, even as the country was careening toward a fall coronavirus surge. A CNN analysis of the Florida state official numbers, aggregated by the Covid Tracking Project, shows that testing dropped off at the end of July and early August, with a peak seven-day average over 90,000 tests per day on July 18. Six weeks later, in early September, the seven-day average dropped by nearly half, with fewer than 48,000 tests per day, and hovered between there and 60,000 during the fall.
If Atlas and DeSantis' advocacy in Florida is, in fact, responsible for the state's testing decrease, that would be in keeping with the wishes of Trump, who for months has falsely suggested that the US has so many coronavirus cases only because it conducts so many tests. In June, Trump even said publicly that he wanted to "slow the testing down, please."
Though both Atlas and DeSantis declined to discuss their views with CNN for this story, they have articulated them in public. Some state and local officials believe the pair was influential in taking Trump's anti-testing pronouncements and helping to turn them into public policy. And the drop-off in testing is of deep concern to some. It took place as positivity rates remained high, in the range that the Centers for Disease Control and Prevention considers indicative of high community spread.
Asymptomatic Covid-19 carriers are still contagious, experts say. A lack of widespread testing makes it harder to map the disease as it spreads and to warn those at risk of illness.
"There's no question more people are going to die," says Miami Beach Mayor Dan Gelber, a critic of DeSantis' approach to testing and other matters of the governor's pandemic management. "We are flying blind without tests."
At the moment, the nation is experiencing another surge of illness. Daily case numbers are reaching levels not seen since late July, and Florida is starting to see its numbers go up as well. Experts say that widespread testing, including of asymptomatic carriers, is critical to limiting the spread of the virus.
A White House spokesman claimed Atlas had never advocated reducing testing, despite the doctor's public statements to the contrary.
Atlas and the President "are focused on using the massive testing program smartly, to save lives and protect individuals at risk in high-risk settings," Judd Deere wrote in an email to CNN. "The administration's testing strategy, and Dr. Atlas's advisement, is fundamentally rooted in the bedrock objective of saving lives, while helping schools, businesses, churches, and other institutions, to open, re-open, and stay open."
A spokesperson for DeSantis said he is acting of his own accord.
"We aren't marching lockstep with anybody," said Fred Piccolo, communications director for the governor. "We respect Dr. Atlas. But we have no marching orders from the White House."
Atlas: From Fox commentator to trusted Trump adviser
After advising the White House for several weeks, Atlas officially joined the Trump administration on August 10 at the request of the President. Trump had seen Atlas in interviews on Fox News, where he expressed skepticism about the scientific consensus on Covid-19.
Among other things, Atlas had asserted that it doesn't matter "how many cases" there are in the US. His thoughts jibed with Trump's, and, upon announcing his hire, the President promised Atlas would "take it to a new level," suggesting Atlas would help the administration tackle the pandemic.
Atlas quickly assumed the role of Trump's most favored public health adviser, supplanting more established members of the coronavirus task force such as Dr. Anthony Fauci and Dr. Deborah Birx. The President hardly ever asks doctors on the task force for their counsel anymore, White House officials have told CNN, relying instead on Atlas.
"I definitely don't have his ear as much as Scott Atlas right now," Fauci said of Trump on MSNBC on Friday. "That has been a changing situation."
John Cochrane, a scholar at the Hoover Institution at Stanford University, where Atlas is a senior fellow, defended his colleague's willingness to push back against consensus.
"Wise public policy has to balance a bit of disease spread against immense economic [and] social costs," said Cochrane, an economist. "I think that underlying insight drives much of his particular recommendations."
One of Atlas' earliest moves as a member of the task force was to work to revise CDC guidelines in order to de-emphasize the need for asymptomatic testing, according to two sources familiar with the process.
The advisory was later reversed because of the objections of CDC scientists, but the short-lived guidelines demonstrated Atlas' sway and helped him spread a message, including in Florida.
DeSantis shares some Trump ideas about the pandemic
Meanwhile, DeSantis has focused on similar things.
Following Trump's demands in July that schools across the country reopen, the governor became a vocal proponent of returning Florida schools to normal operations. DeSantis supported an emergency order issued by his education commissioner in July that public schools should prepare to open five days a week for in-person learning, comparing schools to open retailers like Walmart and Home Depot.
He also criticized some universities in the state for what he called "draconian" punishments for students who violated Covid-19 protocols.
So it was notable that Atlas joined DeSantis in Florida during the first week of classes at the state's flagship public university, the University of Florida. Starting on August 31, the pair went across the state, promoting their shared ideas about the importance of reopening schools, focusing on protecting the elderly and not testing asymptomatic people.
As the Republican governor of a crucial swing state, DeSantis had been presenting Florida's reopening at the end of September as a model of the President's view that life should return to normal quickly.
"The point of all these things are to save lives," Atlas said in summing up his viewpoint at a news conference alongside DeSantis that same day, "not to document asymptomatic people that are low-risk."
"I have been speaking with Gov. DeSantis for quite a while about the pandemic, and he really is an example of doing something with the exact thoughtful approach that we need in this," Atlas said later that day at a joint news conference in Tampa.
During their joint tour, DeSantis and Atlas gave multiple news conferences and met privately with public health experts and officials to expound on their shared views. In one private meeting on August 31, DeSantis and Atlas told a room of health officials they shouldn't be testing college students without symptoms, according to one official who was present.
"It was very clear that the governor was fully bought in on that idea and that we were essentially chastised," the official said of his personal impression from the meeting.
The general tone, the person said, was like DeSantis had gone to Cape Canaveral and given a lecture on rocket science. It was like "so, let me tell you how it works," the source said. "First the fire comes out of the rocket, then the rocket blasts off, then the rocket reaches the blue part of the sky, then it reaches the black part of the sky, then it's in space."
An aide to DeSantis said the governor is simply focused on protecting the vulnerable and reopening the economy.
He believes that lockdowns are "a misguided and counterproductive strategy to defeating coronavirus," spokesman Piccolo said.
Immunizing the herd
The idea that asymptomatic people should not be tested is highly controversial among infectious disease experts.
"There is no way to hide the pandemic by not testing," said Dr. Jennifer Nuzzo, a senior scholar at the Center for Health Security at Johns Hopkins University. "Even if we don't count the people who have mild or no symptoms, they still have it, and they're still infectious to others, and it will show up eventually."
On the other hand, believers in a theory of "herd immunity" are less interested in universal testing. The White House and Atlas have spoken positively of the work of a group of infectious disease specialists who, in a statement called the Great Barrington Declaration, call for opening the economy and allowing rampant infection to create widespread immunity.
In September, DeSantis appeared in a virtual public conference with two key authors of the declaration group, according to multiple local news accounts. The next day, he suddenly announced the complete reopening of the state, without restrictions for businesses or schools and no mask-wearing mandates. One mayor said he was not notified in advance, nor invited to public hearings.
"Everybody was surprised," said Gelber, the Miami Beach mayor. "There had been no warning."