A coronavirus ‘czar’? Trump took the opposite course: a 12-member committee

WASHINGTON — President Obama had an Ebola “czar.’’ George W. Bush and Clinton had AIDS czars. So as the outbreak from China spreads, some lawmakers and public health experts say that an obvious step is for President Trump to appoint a White House-level coordinator, a coronavirus “czar.’’

What works best, they said, is to have a quarterback who has both the ear of the president and the backing to corral the sprawling federal agencies that would respond to an epidemic.

“There is a lot of great work being done by experts throughout our federal health and research agencies, but there is no overarching coordination and strategy,” Sen. Edward Markey (D-Mass.) told STAT. The position, he added, should be permanent and based at the National Security Council, “not just for coronavirus, but for every threatening infectious disease that emerges.”

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This week, President Trump took the opposite approach. Rather than a single overseer, he appointed a committee of 12 headed by Health and Human Services Secretary Alex Azar that includes Centers for Disease Control Director Robert Redfield and Anthony Fauci, who heads the National Institute of Allergy and Infectious Diseases. It also includes national security adviser Robert O’Brien and domestic policy council director Joseph Grogan. The State Department, Homeland Security, and Department of Transportation have delegates on the committee, as well as the Office of Management and Budget.

While some question Trump’s strategy, others said they were not convinced a coordinator role would suit this White House.

Josh Michaud, associate director for global health policy at the Kaiser Family Foundation, said it was not essential to have a czar just yet.

“A trigger would be if we had sustained human-to-human transmission inside the United States,’’ he said. But it would be a hard role to fill: “We would need someone who could act in a nonpartisan way in a very highly charged political environment now, and someone who would have the faith, the trust from the president to take on that thorny issue.” 

Michaud warned: “It could go wrong in a million ways.’’ 

Ronald Klain, Obama’s Ebola czar, told STAT that ideally there should be a czar.

“The issue is whether this president — who likes to listen only to loyalists, who disdains experts, who rejects science and trusts his dubious instincts above all — will listen to these talented men and women,” said Klain, who is advising the presidential campaign of former Vice President Joe Biden.

He added: “Such a coordinator is necessary to manage an ‘all of government’ response, hold agencies accountable for their deliverables, and make sure a comprehensive funding package is being advanced on Capitol Hill.’’

Not everyone embraces the idea of a czar.

“No, because I think they’re well-coordinated between the CDC, the NIH, the FDA, the assistant secretary for health. These are absolutely first-rate people,” said Rep. Donna Shalala (D-Fla.), who was HHS secretary under former President Clinton. 

Czar or not, one challenge for this White House is to resist bad advice about how to grapple with the coronavirus. In one example, Commerce Secretary Wilbur Ross has been widely disparaged for saying the outbreak could mean more jobs for Americans.

Jennifer Nuzzo of the Johns Hopkins Center for Health Security, put it this way: “I could imagine some policy decisions that might sound like good politics but that could do more harm than good.’’

She said she’s expecting more calls for travel and trade restrictions, but warned that such efforts could backfire.

“Given the fact that much of our essential medical supplies are produced in and come from China,’’ Nuzzo said, “if we penalize China, it could work against our best interests.”