“It’s complicated,” said Celine Gounder, who sits on Biden’s Covid-19 advisory board. “It’s almost as if she was politicized herself.”
Birx’s fate deliberations represent one of the few uncertainties for a Biden transition that has spent months planning a complete overhaul of the government’s coronavirus efforts.
The new administration is expected to replace almost all of President Donald Trump’s task force leadership. This has been dubbed “house cleaning” by a transitional official to signal a sharp break with a federal response under Trump that has been viewed as downright disastrous.
Only the top infectious disease expert Anthony Fauci is guaranteed to be part of Biden’s pandemic team, where he is likely to assume an elevated role as one of the government’s best-known messengers. And even among Birx’s most ardent defenders, it is recognized that she cannot remain in a prominent role in directing the crisis response.
Birx declined to comment and the Biden transition team did not answer a series of questions.
Unlike most of the top Trump task force officials, however, Birx is not a Trump commissioner, but has worked in various parts of the federal government for decades Public health bureaucracy and, more recently, US ambassador and global AIDS coordinator under President Barack Obama.
She continues to receive support from public health experts inside and outside the government, including close ties with Fauci, a longtime friend and mentor.
In recent months, Birx has also distanced herself from the White House’s herd immunity to the virus and remains closely involved in day-to-day efforts to fight the pandemic even as her influence within the Oval Office has waned, warning state officials that the situation is so will only continue to deteriorate without stricter compliance with health measures such as wearing masks.
Those efforts have won their goodwill from some Biden officials, who said Birx will be an integral part of the transition process at the beginning and possibly beyond – especially as the new administration is busy absorbing the large amount of pandemic data that is needed their reaction work is of central importance.
“Your understanding of the delivery system and state and local resources is likely very high right now,” said Eric Goosby, a member of Biden’s Covid-19 Advisory Board, who counts Birx as a friend. “It would be critical in the transition and helpful afterwards.”
Birx, 64, has also built relationships with governors and state health officials, making her a potentially valuable link for an administration that depends heavily on states to collaborate on key priorities – from imposing masked mandates to managing the distribution of one possible vaccine.
For a Biden team that won the White House in part on a promise to change course on Trump’s coronavirus policy, all of Birx’s expertise and connections may not be enough to outweigh their association with the president.
At the start of the pandemic, she accompanied Trump to press conferences at the White House for weeks and cemented herself as one of the most prominent faces of the largely failed response, several people near the Biden transition said.
During this time, she often assumed the optimistic tone of the administration, although it became clear that the virus was spreading out of control. And in an April episode, often cited by critics as the cause of death for her credibility, she waved off Trump’s suggestion that “injecting” disinfectant into a person could deter Covid-19.
“When he gets new information, he likes to talk it out aloud and really have that dialogue – and that was the dialogue he had,” Birx subsequently told Fox News.
That defense sparked an immediate setback and remains the tipping point, even for some of Birx’s staff, who originally hoped it would play an influential role in convincing Trump to step up the federal government’s response – and now to ask why she didn’t quit in protest.
“She looked like an apologist too often in public,” said Gregg Gonsalves, a Yale public health professor who worked with Birx on HIV / AIDS issues. “It is not a good sign of confidence as a head of state if nobody knows what you stand for.”
More recently, Birx has been harshly criticized by House Speaker Nancy Pelosi, who in late July told privately senior White House officials that the task force coordinator was “the worst” and complained about “what awful hands” they were in . Pelosi later doubled down downstairs, publicly saying that she had no confidence in Birx.
Senior Democrats and those involved in the transition have also protested over their treatment by the Centers for Disease Control, blaming their clashes with CDC officials over Covid-19 data collection for helping start the Trump administration the agency has overridden and Americans’ trust in public health facilities has declined.
Privately, Birx has told friends that the behind-the-scenes work she’s done to build support for tougher action has been underestimated, and expressed frustration with the direction of the federal response – especially with Trump hiring his health professionals has favor with the consultant Scott Atlas, said those familiar with the talks.
Birx has increasingly partnered with other senior health officials in task force meetings to roll back Atlas’s advocacy for easing public health restrictions, and began a nationwide tour in October to urge state and local officials to step up testing and focus on limiting the virus’ spread.
But for many Democrats, that effort came too late. And since the future Biden administration is already facing the challenge of gaining American confidence in a federal response, it makes little sense to recruit officials who may also be responsible for the decisions of the previous administration.
“I would be stunned if she continued,” said one person just before the transition. “She was too close to Trump and didn’t speak enough to correct facts.”