President Donald Trump and members of the White House coronavirus task force have pressured officials at the Centers for Disease Control and Prevention to change how the agency counts fatalities, a move which would drive down the official death toll, five administration officials told The Daily Beast.
Trump has privately "raised suspicion" about the number of deaths reported across the country, which rose Wednesday to more than 83,000, according to the report. Axios similarly reported last week that Trump had complained about the way that the deaths were counted, "suggesting the real numbers are actually lower."
The president recently told officials the numbers might have been "incorrectly tallied or even inflated by current methodology," two officials told The Daily Beast. Trump wanted the agency to "review" its methodology.
The White House has leaned on the CDC to work with states to change how they count deaths. Dr. Deborah Birx, the coordinator of the coronavirus task force, urged the agency to exclude patients presumed to have died from the virus who did not have positive test results and those who tested positive but may not have died as a direct result of the virus, according to the report.
The pressure has been met with resistance at the CDC, where officials argued that changing the methodology would skew the death rate. The move would be particularly damaging, since officials believe the deaths are being undercounted — not overcounted. Analyses have found thousands of more deaths in certain areas over the past two months compared to the same period in past years.
Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases and a member of the task force, testified Tuesday to a Senate committee that "most of us feel that the number of deaths are likely higher than" what is being reported.
"There may have been people who died at home who did have COVID, who are not counted as COVID because they never really got to the hospital," he said. "The number is likely higher. I don't know exactly what percent higher, but almost certainly it's higher."
But one task force official argued to The Daily Beast that the death rate was a "far-lagging indicator" of the spread of the virus and was "not a real-time indicator of how the virus is affecting the population."
Birx has also privately said there is "nothing from the CDC that I can trust," because she believes the agency's counting method is flawed, according to The Washington Post. Officials at the CDC have sided with Fauci's view.
"The system can always get better, but if we've learned anything, it's that we're seeing some of these individuals who have died of the virus slip through the cracks," one official told The Daily Beast. "It's not that we're overcounting."
"I don't worry about this overreporting issue," Bob Anderson, who heads the Mortality Statistics Branch in CDC's National Center for Health Statistics, told the outlet. "We're almost certainly underestimating the number of deaths."
Anderson explained that his division tracks coronavirus deaths based on local health data and information from states through a death-certificate digital coding system. The local counts are typically higher than the state counts, "but those numbers aren't necessarily inconsistent," he said, since the death certificate count has a two-to-eight-week lag.
In some cases, officials have had to "go back and record those deaths," because they were not properly marked in the state data, he noted, adding that more than 1,500 patients who died of the virus were excluded from early counts.
The report comes after the White House buried a CDC report warning of a possible second wave of infections after states reopen businesses, according to the Associated Press.
Though the Trump administration has tried to control the information released by the agency, CDC Director Robert Redfield painted a dire picture as he testified Tuesday before the Senate.
"It's important to emphasize that we're not out of the woods yet. We need to stay vigilant with social distancing. It remains an imperative," he said. ". . . We need to rebuild our nation's public health infrastructure: data and data analytics, public health laboratory resilience and our nation's public health workforce."
Redfield said the CDC would release a revised version of the guidelines shelved by the White House "soon."
The leaked guidelines urged the public to avoid all nonessential travel until the last phase of reopening, but the White House plan said "non-essential travel can resume" in Phase 2.
"Travel patterns within and between jurisdictions will impact efforts to reduce community transmission, too," the leaked report said. "Coordination across state and local jurisdictions is critical — especially between jurisdictions with different mitigation needs
Fauci also echoed that warning at the hearing.
"My concern is that we will start to see little spikes that will turn into outbreaks," he said. "There is a real risk that you will trigger an outbreak that you might not be able to control — not only leading to some suffering and death — but it could even set you back on the road to get economic recovery."