After it became clear in mid-April that his administration’s response to Covid-19 was threatening his re-election, President Donald Trump considered a leadership shake-up within a health department whose rivalries and battles with the White House had hampered efforts to contain the virus.
Instead, Trump made a different move: He personally intervened to place his campaign aide Michael Caputo — a confidant of disgraced operative Roger Stone who had himself come under scrutiny for his ties to top Russian officials — as assistant Health and Human Services secretary for public affairs. Trump — not HHS Secretary Alex Azar — approached Caputo about the job, and Caputo has repeatedly emphasized that he works for the president, health officials told POLITICO.
Trump’s calculation seemed clear: If he couldn’t easily move aside the health professionals who led the agencies, he could dramatically alter what the public learned about their work on the coronavirus.
Caputo immediately began supplanting career public affairs staff with his own loyalists and Trump veterans – political appointees who often knew little or nothing about health care. They included an old Army buddy to oversee messaging for the Food and Drug Administration, and a former contractor for Medicaid chief Seema Verma to staff the director of the Centers for Disease Control – the two most trusted agencies in a health world that had traditionally been insulated from political pressure.
He also plucked an unpaid, part-time professor from obscurity inside a Canadian university to be his science adviser – and used him to challenge and intimidate the scores of highly credentialed scientists in the CDC and other government agencies.
On Wednesday, after POLITICO detailed Caputo’s efforts to interfere with the weekly scientific reports coming out of the CDC and a disastrous rant in which he accused health officials of plotting against Trump, the 58-year-old spokesman announced he was taking a 60-day medical leave. HHS officials are left to assess the damage to their credibility at a time when they need the public to accept the safety and effectiveness of the coronavirus vaccine they choose as soon as next month.
“He is single-handedly blocking the only window that this administration has that light can shine through,” one HHS official said shortly before Caputo’s leave was confirmed, referring to the spokesman’s efforts to block scientifically vetted messaging about coronavirus. “It’s one man.”
But with Caputo out of the picture, it’s not clear that credibility can be restored so quickly.
Interviews with more than 30 current and former health officials painted a picture of a health department laid low by its own press spokesman in the midst of the worst pandemic in a century. They recounted how Caputo succeeded in installing his own loyalists in positions even outside the communications realm, ordered up a $250 million, taxpayer-funded PR campaign that he himself promised would counter grim official predictions about the coronavirus threat, and sought to stifle experts from the FDA to CDC to the National Institutes of Health.
It's unclear whether any of those initiatives will be rolled back in Caputo’s absence.
Multiple HHS officials said Caputo’s impact on the substance of health policy was limited, but he entirely transformed what the public learned about the government’s response to the virus. Most significantly, Caputo fostered the appearance of political bias in the effort to approve a Covid-19 vaccine, sowing distrust of the FDA at a time when health leaders desperately need people to accept a vaccine in order to create the immunity necessary to defeat the novel coronavirus.
“It didn’t add, it didn’t subtract,” the official said of Caputo's effect on efforts to beat back the pandemic. “It just created a public relations nightmare.”
* * *
Caputo, who first arrived at HHS in mid-April, was originally brought in to fix a different public relations problem.
For months, Azar had clashed with a range of administration officials at the White House and within his own agencies -- battles that often spilled into public view. That included an extended feud with Verma that grew so poisonous that Vice President Mike Pence was forced to step in, and a constant string of disagreements with others during his short-lived tenure as head of the government's coronavirus task force.
As the pandemic spiraled, White House officials had also come to believe Azar was playing a role in reports critical of Trump's early handling of the coronavirus response.
The rising frustration with Azar prompted the White House to try to reassert control, installing Caputo atop HHS's communications office in a bid to exert greater influence over the department and a secretary with few remaining allies in the West Wing.
But Caputo quickly became a lightning rod on his own merits.
Within days of his appointment, Caputo faced a raft of calls for his resignation over unearthed Twitter posts that denigrated Chinese people, attacked political rivals and accused Democrats of rooting for "massive deaths" from the coronavirus.
“The anti-Asian bigot & racist Caputo must be fired today,” Rep. Jamie Raskin (D-Md.) tweeted at the time, one of several Democrats who sought his firing.
A political operative with a reputation as one of Trump's most ardent and combative defenders, Caputo responded by picking fights with media outlets and mocking attempts to dislodge him from his perch at HHS, using rough-and-tumble tactics he'd honed after decades of experience on the political battlefield. Before CNN published a critical story on his deleted tweets, Caputo leaked the reporter's questions to multiple conservative allies. After reporters at The Wall Street Journal privately interviewed Azar and wrote a critical piece on the health secretary, Caputo provided a copy of the recorded interview to a publication that swiftly lambasted the WSJ.
Within some parts of the department, Caputo's hard-nosed approach initially won praise from officials who felt HHS had faced unfair criticism amid an all-consuming pandemic. And as Caputo took a more visible role in the department's operations, Azar's internal standing improved as well.
When a group of White House officials discussed firing the health secretary in late April, Caputo raced to shore up Trump's support for Azar. Less than 24 hours after reports that Azar could be ousted, the president tweeted that the embattled secretary was "doing an excellent job!"
"Azar had one foot on a banana peel and another on a sheet of ice" before Caputo joined HHS, said one former senior Trump administration official, who credited Caputo with taking much of the heat off him.
Yet Caputo, backed by his close friendship with Trump, was also granted broad power within HHS that led to clashes with career officials and politicized day-to-day activities that had not traditionally been subject to political influence.
He found jobs in HHS for at least four close friends and associates, sometimes by creating new high-level positions for them – a practice that some officials privately questioned. Caputo in May hired Gordon Hensley, who served as his spokesperson when he came under scrutiny through Robert Mueller’s probe into Russian interference in the 2016 election, as a health department adviser, and in June added GOP communications consultant Natalie Baldassarre as one of his aides at HHS, after she worked at his old communications firm.
But Caputo’s moves to more closely control public health agencies under HHS’ umbrella prompted the loudest objections. At the FDA, Caputo installed his longtime friend John “Wolf” Wagner in June atop its communications operation. Wagner, who has no scientific background, subsequently instructed the agency’s press staff to give reporters only brief “top line” responses to questions and resisted requests for FDA spokespeople to speak directly with the press on a wide range of topics, said a current and a former FDA official.
Wagner was also involved in the agency’s botched rollout of blood plasma as a coronavirus treatment, an episode that eventually led FDA Commissioner Stephen Hahn to apologize for making claims that overstated the treatment’s benefits. Caputo this month reassigned Wagner to work in the department's preparedness and response agency on efforts to rush a coronavirus vaccine.
Meanwhile, at the CDC, he punctuated an ongoing feud with the agency by helping install the agency's new top communications officer in June with little notice to the agency's senior leadership team.
That official — Nina Witkofsky, who had previously served as a communications contractor helping arrange trips for Verma — in August became the CDC’s acting chief of staff. Witkofsky did not respond to a request for comment about her work or communications with Caputo.
But the Caputo aide who attracted the most controversy was Paul Alexander, an unpaid, part-time professor at McMaster University. Alexander, whose departure was tersely reported by HHS along with Caputo’s medical leave, did not immediately respond to a request for comment.
Brought on as Caputo's science aide in a newly created role this spring, Alexander spent months berating government scientists and trying to edit scientific bulletins written by the Centers for Disease Control, the agency's famed Morbidity and Mortality Weekly Reports or MMWRs, POLITICO first reported on Friday.
In emails, Alexander attacked CDC scientists for trying to “hurt the president” by allegedly skewing their bulletins and seeking to undermine Trump's optimistic message on the pandemic. The behavior was a habit for Alexander: he last week attempted to prevent infectious disease expert Anthony Fauci from discussing the risks of coronavirus for children, and the Washington Post in July reported on Alexander's earlier efforts to chastise CDC officials.
But Alexander had a powerful protector — Caputo, who shared his adviser's belief that a "deep state" inside the government was working to damage Trump before the election.
* * *
After Friday's POLITICO report, Caputo found himself in a new position: rather than fix the story, Caputo was the story.
Prominent public health experts decried his team's efforts to change carefully vetted, rigorously non-partisan scientific texts.
The MMWRs are "required reading, especially during a pandemic," Rich Besser, the CEO of the Robert Wood Johnson Foundation and the former acting head of the CDC, wrote in the Scientific American. "To meddle with, delay or politicize these reports would be a form of scientific blasphemy as well as a breach of public trust that could undermine the nation’s efforts to fight the coronavirus."
Meanwhile, career civil servants inside HHS were horrified that their work could be distorted by a career political consultant who was seeking to protect the president.
Even some Trump appointees who privately admired Caputo's style — praising his efforts to spar with administration critics and attack the media — felt he had gone too far by seeking to edit scientific documents.
"This guy's problem is that he doesn't know where the red line is," said one senior official who believed some of Caputo’s hardball tactics were justified. "Or maybe he sees the red line and he's like a bull, he charges over it."
Besieged by critics and dogged by a personal health concern, Caputo struck a defiant tone in a Facebook Live video he shared with friends on Sunday night, first reported by The New York Times.
"I'm not going anywhere," Caputo said in the video. "You know why? Because the president of the United States supports me."
But the video veered into conspiracy thinking — as Caputo spouted theories about "hit squads" organized by opponents of Trump and urged militia members to stockpile ammunition in case of a disputed election — and featured extended riffs on Caputo's frustrations with Washington, D.C. The health department's top spokesman also lodged more than a dozen attacks on the scientists whose work he was nominally hired to promote.
"These scientists at the Centers for Disease Control, some of them have rotted from the brain out," Caputo said. "They're working against Donald Trump as scientists."
"There are scientists who work for this government who do not want America to get well," Caputo said later in the nearly 30-minute video. "Not until after Joe Biden is president. It's a fact. I know it because I've heard it … these people are all going to hell."
On Monday, a House oversight subcommittee opened an investigation into Caputo's efforts to meddle with the CDC's reports, requesting that he, Alexander and other HHS officials submit for interviews next week.
Senior Democrats also called on Caputo to step down, and Senate Minority Leader Chuck Schumer on Tuesday demanded that Azar himself resign for allowing Caputo and his team to pressure government scientists, among other criticisms. Meanwhile, multiple media outlets dug into Caputo's role at HHS, including his hometown newspaper, which found his stewardship lacking.
"Caputo's ideas about managing a health crisis need to be put out to pasture," wrote the Buffalo News in an editorial on Tuesday, calling on him to resign immediately.
Amid the firestorm, Caputo weighed a potential departure from HHS, consulting with Azar and other senior officials on Tuesday about the logistics of a medical leave, said four individuals close to the situation. Some White House officials began to conclude as well that Caputo had become a distraction and needed to depart — whether medical leave or otherwise.
McMaster University also sought to distance itself from Alexander, with a spokesperson saying that he is not currently teaching at the university nor has he been paid as a part-time assistant professor.
By Wednesday afternoon, the situation had become untenable, and HHS announced that Caputo was taking a 60-day medical absence. The spokesperson's exit potentially sidelines one of Trump's most devoted allies in government at a particularly sensitive time: the election is 48 days away.
HHS also said that Alexander was leaving the department, although didn't offer further details.
Caputo himself spun his departure as a necessary move for his health, in a statement where he praised Fauci, said he'd consulted with Trump and Azar about his next steps and needed to pursue screenings for a recently discovered lymphatic issue.
"[E]very American battling COVID — in every city in every state across the nation — has been under enormous pressure. I am just one of them," Caputo said. "I’ve learned so much in friendship with the doctors of the President’s Coronavirus Task Force."
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