POLITICO spoke with more than 15 officials, volunteers, advisers and private-sector executives directly involved in the White House-backed effort, who described a sprint against time to transform the nation’s Covid-19 response — even as the U.S. outbreak remains among the worst in the world — and insisted that the work was apolitical and shielded from White House pressures.
Officials working with Kushner’s team argue that drive-thru testing taught them the limits of what they could accomplish overnight. “There were tradeoffs,” said one senior administration official. “In the first 48 hours, we calculated that if we ran the [drive-thru] sites full speed, we could burn through 80 percent of the strategic national stockpile of personal protective equipment just on testing.”
The true test of the team’s work awaits in May, as states reopen their economies and millions of Americans head back to work, even as public health officials warn of a “slow burn” of continued infections that could top 200,000 new cases per week and death projections jump as states rush to relax restrictions. In order to contain the ongoing outbreak, there needs to be sufficient surveillance to uncover possible cases — and the White House insists that its rescue effort has secured enough supplies for states to run 8 million diagnostic tests alone in May. There were only about 6 million total tests conducted between January and the end of April.
“We are working with governors to make sure they have all the testing they need to open up safely,” Kushner said.
Dan Bartlett, who runs corporate affairs for Walmart, was cautiously optimistic: “It’s definitely been a well-intentioned process that is complicated, and it’s taken time to find its footing,” he said. The retail giant launched two pilot testing sites in the Chicago area within 10 days of Trump’s remarks; now Walmart is up to more than 40 sites and aiming to scale to more than 100 sites by the end of May, Bartlett said.
Like some of its initiatives, the team behind it has been misunderstood and scorned, largely because of the involvement of one person: Kushner, the president’s son-in-law. Democrats have seized on Kushner’s role, clamoring for investigations and warning that the team may have inappropriately leaned on private sector volunteers.
“I don’t remember any Democrats saying it’s terrible the private sector is helping save Obamacare,” countered conservative policy analyst Avik Roy, adding that key members of Kushner’s team — like Medicare innovation chief Brad Smith, U.S. foreign-investment czar Adam Boehler and Flatiron Health’s Nat Turner — have proven track records as health care entrepreneurs.
“I think they’ve made a huge difference,” Roy added. “You take a bunch of dedicated government officials … [and] layer on to that Adam, Brad and Nat are exceptionally talented and capable. You have the workings of a group that can actually move mountains.”
A coronavirus rescue team
That progress began late on March 11, where for the first time Trump appeared to grapple with the nation’s spreading coronavirus outbreak, after weeks of minimizing the risk.
“We are marshalling the full power of the federal government and the private sector to protect the American people,” the president said in a rare Oval Office address to the nation. “This is the most aggressive and comprehensive effort to confront a foreign virus in modern history.”
The president’s remarks were filled with glitches about new travel restrictions — reflecting the rushed pivot to address the virus’ severe threat — and they were partially scripted by Kushner, who off-camera was beginning to pull together the private sector efforts that Trump had just promised. By the next morning, he had recruited his longtime friend Boehler, an entrepreneur who first joined the administration’s health department in 2018 before shifting to a role last year overseeing U.S. investment in developing countries.
In a meeting at the Eisenhower Executive Office Building next to the White House, Kushner, Boehler, national security official Matt Pottinger, Trump policy aide Chris Liddell and other staff walked through the state of the nation’s response. Kushner and Boehler then conferred on four key priorities, including the possibility of launching drive-thru testing sites modeled on South Korea’s popular model.
Smith, the newly installed head of Medicare’s innovation center, hadn’t been involved in the Covid-19 efforts to that point. (In fact, having just joined the Trump administration in January, Smith was still learning the many acronyms associated with his job and getting acquainted with his team, which was holding a meeting on social determinants of health that morning.) But Boehler — who had spent months recruiting Smith to the administration, convincing his one-time private sector competitor to walk away from a business startup — summoned him to the White House, where Smith was tapped to be the operations manager for the fledgling coronavirus rescue effort. The two health care entrepreneurs and dozens of other staff soon crowded into the Office of American Innovation, housed in the basement of the West Wing, as Kushner rounded through the office and laid out instructions.
Calls were quickly placed to retailers like Walmart to enlist their support and services, and to Obama administration veterans like Andy Slavitt, who’d helped lead the team to fix the broken HealthCare.gov website six years ago and became an outside adviser to the new group.
Meanwhile, Brett Giroir, a top Trump appointee in the health department, was tapped as the nation’s new testing coordinator — an overdue move to address the badly broken response. Giroir, who had been acting head of the Food and Drug Administration in late 2019, had spent recent days at the Centers for Disease Control in Atlanta, trying to uncover what had gone wrong after the agency’s troubled efforts to produce a coronavirus test. Those stints at FDA and CDC would help him understand the regulatory environment to speed tests to market, Giroir would tell colleagues.
A focus on drive-thru sites
By the morning of March 13, the new team had settled on the drive-thru testing project as its first priority, only a few hours before Trump would make the announcement in the Rose Garden.
But they faced several practical challenges, including one major operational problem: “No one in the government had ever set up something like a drive-thru testing site before,” said Smith. “It turned out that actually doing that was pretty hard.”
The team’s leaders turned to members of the Commissioned Corps — the nation’s uniformed public health team, who work under the Surgeon General — who had recently returned from coronavirus-infested cruise ships in order to figure out the potential workflow of how testing would even work. Across the weekend, the team determined what testing materials and personal protective equipment each drive-thru site would need — and after discovering that the strategic national stockpile only had about half the necessary supplies, conducted its own efforts to locate and acquire them.