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Reopen the schools, diminish the seriousness of the coronavirus pandemic, and the economy comes first. President Trump and White House aides have been pushing these views for months. Now a top public health official is joining the chorus.

In a new podcast, and in other public statements, the head of the Substance Abuse and Mental Health Services Administration (SAMHSA) strongly echoes the president’s talking points on reopening schools and businesses, angering current and former agency officials who say she is politicizing the office and reinforcing administration arguments about Covid-19 that aren’t supported by sound scientific evidence.

“What is this nonsense that somehow it’s unsafe to return to school?” SAMHSA administrator Elinore McCance-Katz says, unprompted, midway through a podcast posted last week on the website of the Department of Health and Human Services. At another point she says, “There was no agreement to this, to this nonstop restriction and quarantining and isolation and taking away anything that makes people happy.  … You can’t go to a movie, you can’t go to a football game.”

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A psychiatrist with a Ph.D. in infectious disease epidemiology from Yale, McCance-Katz argues during the podcast that the harsh steps taken to contain the pandemic in the spring were excessive. “I’m going to say it,” she said. “We shut down the entire country before the virus, in my opinion, had a chance to get around the entire country. … We used a sledgehammer when I think we needed a scalpel.”

Even with an administration where political appointees atop health agencies are expected to stand behind the president’s handling of the Covid-19 crisis, former agency officials were taken aback by her comments.

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Regina LaBelle, chief of staff in the White House Office of National Drug Control Policy during the Obama administration, said when she heard the last line of the podcast — “paid for by taxpayers” — she started laughing. “It’s so blatantly political and cynical, and it breaks my heart to see this,” said LaBelle, now program director of the Addiction and Public Policy Initiative at the Georgetown University Law Center. “Families are suffering and they deserve to be treated with respect by their government.”

“I’ve always had great respect for her,” LaBelle said of McCance-Katz, but as a political appointee, she’s in “a bubble of the machinery of government. And right now, the machinery of government is being used to reelect the president.”

The podcast is part of a series in which Michael Caputo, a former Trump campaign official appointed as HHS assistant secretary for public affairs in April, interviews department officials. Caputo has become a controversial figure at HHS. His communications team has been pressuring the Centers for Disease Control and Prevention to water down weekly scientific reports on Covid-19 to more closely align with the president’s optimistic views about the course of the pandemic, Politico reported last week. And over the weekend, according to the New York Times, Caputo claimed on Facebook, without evidence, that government scientists were engaging in “sedition” and that left-wing hit squads were preparing for armed insurrection after the election.

The podcasts are posted on the HHS website and distributed through popular platforms, including Apple, Google Play, and Spotify. “Each episode takes the listener behind the scenes at HHS as the experts explain what they’re working on and what you need to know,” an HHS spokesman said.

In the latest podcast, McCance-Katz says reopening schools and businesses is essential for people’s mental health. “There was a study published just a few months ago that said, for every 1% increase in unemployment, we will see an additional 1.3% jump in our suicides,” she says. “So, this is going to be a hugely terrible but important issue for us to address.”

Caputo tells McCance-Katz that the opposition to reopening schools is political, to which she responds, “It makes no sense.”

McCance-Katz, appointed to lead SAMHSA by Trump in 2017, never once challenges Caputo in the podcast – not even when Caputo, the top communications official at HHS, says, “I don’t think the United States media gives a damn about public health information.”

“I don’t too,” McCance-Katz responds.

Bob Lubran, until the end of 2016 the head of SAMHSA’s Division of Pharmacologic Therapies, said he believes McCance-Katz is being pressured to make such comments. “I view that as taking the party line,” he said. “I can’t imagine she would volunteer to do that.”

Another former agency employee, who knew McCance-Katz well, was blunter, saying: “She drank the Kool-Aid.” Like many former and current officials interviewed for this article, this person didn’t want to be identified, fearing retaliation.

McCance-Katz did not respond to an emailed request for comment, nor did spokespersons for SAMHSA and HHS.

SAMHSA leads public health efforts to reduce substance use and mental illness. McCance-Katz was its first chief medical officer, during the Obama administration, but left, afterward writing a scathing letter to Psychiatric Times in which she criticized the agency for not caring adequately for people with serious mental illness. She was brought back by President Trump as assistant secretary for mental health and substance use at HHS at the beginning of his term.

There have been other instances in which McCance-Katz has aligned herself with Trump’s views on the response to Covid-19. In mid-August, she wrote an op-ed in USA Today calling for schools to reopen. She cited the American Academy of Pediatrics (AAP) policy, which urged the return of children to classrooms, but she did not mention the AAP’s caveat that the reopening proceed only if it could be done safely.

“What the data shows clearly is that when schools reopen and community spread has not been adequately controlled, you will have infection in kids and teachers and parents,” Nathaniel Beers, a pediatrician who serves as an AAP spokesman and on its Council of School Health, told STAT.

Children are part of a social network, said H. Westley Clark, former director of SAMHSA’s Center for Substance Abuse Treatment, citing a CDC study that found children infected with the coronavirus at child care facilities had transmitted it to household members. “We have to ask how a child would feel if he/she infects his/her parent, especially if that parent is incapacitated by SARS-CoV-2 brought home by the child,” added Clark, a psychiatrist who is now a dean’s executive professor at Santa Clara University. “Remember, communities of color have been disproportionately affected by Covid-19.”

McCance-Katz also told President Trump during a May 19 Cabinet meeting that it’s vital to reopen the economy. “To put all of this in perspective, I believe it is important to point out that, pre-pandemic, we lose 120,000 lives a year to drug overdose and suicide. How many more lives are we willing to sacrifice in the name of containing the virus?” she said.

At the time, there had been more than 90,000 Covid-19 deaths reported in the U.S. in just three months, and the total is now nearing 200,000.

“When we look at strategies to reopen, as a medical doctor, I ask that you take into account whole health, not just one narrow aspect of physical health,” said McCance-Katz at the White House meeting. “We continually ask ourselves what the health costs and risks may be of reopening, but I ask: What might they be of not reopening or reopening in such a restrictive way that American lives are not restored?”

“As a psychiatrist, I would argue that a life lost to suicide is just as important as a life lost to coronavirus,” she concluded, calling the virus only “one metric,” and adding: “Virus containment cannot be our only goal, no matter the cost to Americans.”

McCance-Katz made no mention of the fact that lockdowns were deemed necessary by public health officials to “flatten the curve” in the spring and keep the U.S. health care system from being overwhelmed.

“Yes, overdoses are increasing and suicide is increasing, probably related to a lot of things including coronavirus,” one former SAMHSA employee told STAT. “Probably everybody in the United States has some form of generalized anxiety disorder right now, but is it ethical to say that we will reduce the suicide and overdose rates by reopening? We don’t know what we don’t know. It’s bad logic.”

STAT interviewed six former senior SAMHSA officials for this article, three other former high-level federal officials, and seven agency contractors and grantees, and most didn’t want their names used, citing fears that they could be retaliated against. Former officials said they feared their current employers risked losing agency funding if they spoke openly.

“As a former SAMHSA employee,” one person said, “I have seen the vindictiveness of this administration and her [McCance-Katz’s] henchpeople firsthand towards those who challenge the status quo, and I can’t afford to put [my organization] in the line of fire.”

  • “..arguments about Covid-19 that aren’t supported by sound scientific evidence.”

    CDC’s Infection Fatality Ratio for 0-19 years: 0.00003. This is statistically zero. There are a dozen things children may die from above Covid.

    Covid-19 turned out to be a category 2 pandemic on the Pandemic Severity Index. In the CDC’s “Goals of Community Measures” pandemic mitigation strategy, (developed by scientists when cooler heads prevailed) to guide policy making; keeping children out of school for less than 4 weeks was a “consider”, not even “recommended” for cat 2 and 3. There’s stratification even within that, where the cat 3 would be “considered” more than the 2.

    We are still treating Covid-19 as a cat 4, or 5 pandemic and have abandoned the guidelines. I worked in research science most of my career and am politically agnostic. I find it strange anyone going against the notion this isn’t the apocalypse is labeled a “science denier”, or something along those lines. Medical science is only one science, but for too many it’s the only seat at the table. The sciences of economics, pedagogy, psychology, sociology and politics must have a seat too. Children clearly should be in school.

    • Wasn’t the Pandemic Severity Index abandoned as an index for measuring the severity of a pandemic because it has very crude criteria to gauge all of the factors involved? I thought it was replaced by a much more comprehensive Pandemic Severity Assessment Framework. I see that the CDC used this methodology to assess the H1N1 influenza pandemic; I wonder why it’s not currently being used?

  • Trump has no point of view other than that the virus will “go away” some day. Uh-huh, so will we all but CDC personnel who want a little science with their “elect me at any cost” politics are called “seditious?”

    And Dr. McCance-Katz, a Yale-trained psychiatrist provides no data to support her toe-the-line perspective?

    The point is that Americans need real data, not conspiratorial opinions (or 22,000+ lies so far from their POTUS), to arrive at their own conclusions sensibly.

    We can certainly disagree but should know whatever truths our government does without being erroneously labeled “deep-staters.”

    Note all who were afraid of retaliation as sources for this article.

  • Political appointees are chosen and appointed by the President in order to carry out the policies of the President.

  • It is sheer politicisation to automatically criticise a qualified and professional government medical official because what he or she says may seem to back positions the White House

    There are many studies that point to the fact that draconian lockdowns are enormously damaging to people’s lives, their livelihoods, their mental health, their general health where many other diseases are neglected, domestic violence, addictions, suicides — I can go on further …

    This cure is worse than the disease ..

    Further evidence points to the fact that total lockdowns don’t in fact achieve their objectives and leave populations immunologically naive when, as they inevitably must, the shattering lockdowns are lifted

    Quarantine the vulnerables and let others go to schools and work ( albeit with masking , hand washing etc to slow the inevitable spread toward herd immunity ) ie towards the successful Swedish model which leaves the economy much less trammelled, is the better policy ..

    Total lockdowns were only appropriate when we knew little of the epidemiology and were designed to protect hospitals from potential inundation

    Things have changed – the population death rates have dropped precipitously and it is now shown by far most younger and healthy are either asymptomatic or mildly ill …

    Positive tests should not be counted as “cases” – only those developing illness should. That’s how it’s always been up to now. Massive public policy moves based on “cases” are a major mistake …

    This doesn’t deserve the draconian actions that are still being taken…

    Partial prophylaxis with selected nutrient supplements (quercitin; zinc; vitamins D, C and B complex ; selenium etc) and early treatments with the Selenko or Borody protocols ( increasingly being adopted worldwide ) make the outlook much less fearsome as well

    • Fully agree, also with Reniam´s comment above. It is heartbreaking, as a European, to see how regarding Covid-19 in the US science have been messed up with politics.

  • So former Obama officials agree that the Trump administration members are “reinforcing administration arguments about Covid-19 that aren’t supported by sound scientific evidence.” Exactly which facts? That kids are less susceptible to C19? That closing down the economy hurts the most vulnerable and increases mental health and substance abuse issues? Does the writing team at STAT EVER reference scientific sources including the realities of trade offs and impacts of government shutdowns- it appears not. Just a political rag masquerading as a scientific pub.

    • John Abeles, well said.

      I just did a quick search on STAT for “Harvey Risch.”

      Not a single reference came up.

      Why? Risch wrote an article for the American Journal of Epidemiology arguing that hydroxychloroquine is possibly an effective treatment for Covid especially for certain types of patients at certain disease stages.

      Who is Harvey Risch?

      He is Associate Editor of the Journal of the National Cancer Institute, Editor of the International Journal of Cancer, and Member of the Board of Editors, the American Journal of Epidemiology an author of more than 325 peer reviewed papers.

      But the writers at STAT will go, “Well, tut, tut, harumpf, harumpt” about the potential flaws of interesting studies, such as the recent Henry Ford study.

      Want even more proof, if any were needed, that STAT and its journalists have above all a POLITICAL agenda rather than a SCIENCE agenda?

      Q.E.D.

  • What about the mental health of those of us despairing at the constant lying and disinformation, and politicization of, well, everything? To see once trusted healthcare and other governmental institutions caving in to the lunatics in charge right now is beyond disheartening.

  • It is insane that Trump is using his appointed officials to spread his unscientific propaganda, all in an effort to get re-elected.

    Never did I expect to see this here in the US.

  • Remember now….doctors are only to be taken seriously when they further the cause of voting out Trump. Daring to say there are other factors other than covid is not allowed.

    This is ending by spring. One way or another.

    • Doctors are to be taken seriously when they actually follow science.

      The Trump administration has taken the route of ignoring the science and, instead, saying whatever will make Trump look good.

      Considering the idiotic statements Trump has made about Covid, it’s hilarious to watch his henchmen twist themselves into pretzels trying to make it seem he’s correct.

    • May not be too much of a quarantine that is a problem. If a “true” quarantine method was in place, it might be possible to beat this virus. But if all you do when you are sick is go home to your apartment building or condo or home, how is that preventing spread of infection in any meaningful way? What is needed is some kind of bullet train that you load the infected on and it sends them to an isolation area in a remote desolate part of South Dakota. Right now we have the luxury of loose, informal isolation. If this virus mutates in a negative direction to something more deadly, we won’t have the luxury of loose informal stay-at-home social distancing. Rigorous quarantine methods will be required. CDC and HHS should have planned this out years . If they had, we would already be able to use it now.

  • “drunk the kool aid?” Some might say it is refreshing to hear a differing view for Stat readers. How can we ever come to consensus unless we allow dissent?

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