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Re: U.S. government gave $3.7 million grant to Wuhan lab at

Postby admin » Tue Dec 22, 2020 2:24 am

What we know -- and what we don't -- about the UK coronavirus variant
by Zamira Rahim
CNN
Updated 3:45 PM ET, Mon December 21, 2020

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(CNN) The United Kingdom has identified a new, potentially more contagious coronavirus variant linked to a recent surge in cases in England.

The new variant is being called VUI-202012/01 -- the first "Variant Under Investigation" in the UK in December 2020. While scientists hunt for more information about the variant, its impact is already being felt.

Multiple countries have now imposed restrictions on travelers from the UK. British Health Secretary Matt Hancock said Sunday that the variant was "out of control" and Prime Minister Boris Johnson chaired an emergency meeting Monday as his government tried to manage the fallout.

Here's what you need to know.

What is a variant and why are officials concerned about this one?

A variant occurs when the genetic structure of a virus changes, according to the US Centers for Disease Control and Prevention. All viruses mutate over time and new variants are common, including for the novel coronavirus.

As with other new variants or strains of Covid-19, this one carries a genetic fingerprint that makes it easy to track, and it happens to be one that is now common. That alone does not necessarily mean the mutation has made it spread more easily, nor does it not necessarily mean this variation is more dangerous.

However, the UK government's New and Emerging Respiratory Virus Threats Advisory Group said it had "moderate confidence" that this new variant "demonstrates a substantial increase in transmissibility compared to other variants."

Chris Whitty, England's chief medical officer, said this particular variant "contains 23 different changes," which he described as an unusually large number. Whitty said the variant was responsible for 60% of new infections in London, which have nearly doubled in the last week alone.


On Monday, Chief Scientific Adviser Patrick Vallance added that he anticipated the spread of the new variant would increase after Christmas.

"Given that we're entering a period of inevitable mixing, I think there will be some increases in numbers over the next few weeks," he said, adding that local restrictions are likely to be tightened rather than eased in the new year.

That finding has immediate implications for virus control. More cases could place an even greater strain on hospitals and health care staff just as they enter an already particularly difficult winter period, and ultimately lead to more deaths.

Public Health England (PHE) has said that a mutation in the Covid-19 spike protein, the part of the virus that attaches itself to host cells, could increase its transmissibility. Scientists across the UK are conducting more research on this issue.

Where did the variant originate and how has it taken hold?

The new variant of Covid-19 originated in southeast England, according to the World Health Organization.

PHE have said that backwards tracing, using genetic evidence, suggests the variant first emerged in England in September. It then circulated in very low levels until mid-November.

"The increase in cases linked to the new variant first came to light in late November when PHE was investigating why infection rates in Kent [in southeast England] were not falling despite national restrictions. We then discovered a cluster linked to this variant spreading rapidly into London and Essex," PHE said.

Multiple experts have also suggested that this new variant could have been amplified because of a superspreader event, meaning the current spike in cases could also have been caused by human behavior.

"A higher genomic growth rate in the samples sequenced, may not necessarily mean higher transmissibility, e.g. if there was a rave of several thousand people where this variant was introduced and infected many people mostly in that rave, this may seem very high compared to a lower background of non-variant virus," Julian Tang, clinical virologist at the University of Leicester, told the Science Media Centre.

Which countries are affected?

The variant has already spread globally. As well as the UK, the variant has also been detected in Denmark, Belgium, the Netherlands and Australia, according to the WHO.

Australia has identified two cases of the variant in a quarantined area in Sydney and Italy has also identified one patient infected with the variant.

A similar but separate variant has also been identified in South Africa, where scientists say it is spreading quickly along coastal areas of the country.

Is the new variant more deadly?

There is no evidence to suggest that the new variant is more deadly as of now, according to Whitty, who said that "urgent work" was underway on Saturday examining the implications for mortality.

"We are not seeing any increased virulence (clinical severity) or any gross changes in the [spike protein] that will reduce vaccine effectiveness -- so far," Tang told the Science Media Centre (SMC.)

Multiple experts have pointed out that for some viruses increasing transmissability can accompany decreasing virulence and mortality rates. This may mean that the variant is less lethal, though it's currently too early to tell.

"New viruses will adapt to a new host over time -- with decreasing mortality, and possibly increasing transmissibility," Tang said.

"As viruses are transmitted, those that allow for increased virological 'success' can be selected for, which changes the properties of the virus over time. This typically leads to more transmission and less virulence," Martin Hibberd, professor of emerging infectious disease at the London School of Hygiene & Tropical Medicine, said to the SMC.

Will the developed vaccines work against this variant?

Whitty said Saturday that current vaccines should still work against the new variant.

His remarks were echoed in the US by the head of Operation Warp Speed. "Up to now, I don't think there has been a single variant that would be resistant to the vaccine," Moncef Slaoui told CNN on Sunday. "We can't exclude it, but it's not there now."

The UK, the US and the EU have authorized the Pfizer/BioNTech Covid-19 vaccine and several others are in development.

What measures are being taken to contain the variant?

England's chief medical officer has urged people in Britain to take steps to reduce the virus' spread.

"Given this latest development it is now more vital than ever that the public continue to take action in their area to reduce transmission," Whitty said on Saturday.

Large swathes of England, including London and the southeast, are now under strict Tier 4 Covid-19 restrictions, which is only the latest disruption to a Christmas holiday shadowed by the pandemic.

Dozens of countries across Europe, the Middle East and the Americas have also announced travel bans for the UK.

Others, such as Greece and Spain, have imposed restrictions that require travelers arriving from Britain to undergo coronavirus tests or quarantine.

America's top infectious disease expert, Dr. Anthony Fauci, told CNN on Monday that he would advise against additional restrictions on UK travel. The US must "without a doubt keep an eye on it," Fauci said, but "we don't want to overreact."

The US has maintained a ban on travel from the UK, Ireland, and Europe's Schengen zone as well as number of other countries since March.
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Re: U.S. government gave $3.7 million grant to Wuhan lab at

Postby admin » Wed Dec 23, 2020 3:04 am

Hospital releases video showing dire COVID crisis in California
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Postby admin » Wed Dec 23, 2020 6:02 am

White House security director has part of leg amputated after falling severely ill with COVID-19, fundraiser says: It is the most serious publicly reported case linked to the White House.
by Ben Gittleson
abcnews.go.com
December 16, 2020, 2:04 PM

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The director of the White House security office, Crede Bailey, was in an intensive care unit for three months and had part of his leg amputated after contracting COVID-19 several months ago, according to a fundraising campaign set up to help him.

Bailey, who recently moved to a full-time rehabilitation facility, now faces significant medical bills, according to the online fundraiser. He was hospitalized in September after falling ill with the coronavirus, people familiar with his condition told ABC News.

His illness came as dozens of White House staffers and allies of President Donald Trump tested positive for COVID-19 in a series of outbreaks tied to the White House. Among them were the president, first lady and their teenage son.

While a number of coronavirus cases were linked to a Sept. 26 White House celebration for then-Supreme Court nominee Amy Coney Barrett, Bailey had been hospitalized before the event, according to the people familiar with his situation.

According to the fundraising page, Bailey suffered permanent injuries from his bout with COVID-19, including the amputations of his right foot, lower right leg, and big toe on his left foot.

In appealing for donations, the person listed as the campaign's organizer, Dawn McCrobie, wrote that Bailey would need to pay for a prosthetic leg, a wheelchair and modifications to his home, among other medical expenses. McCrobie said that "even with insurance," the expenses were "astronomical."

McCrobie did not respond to requests for comment. Bailey and his relatives also did not respond to requests for comment.

The White House last week declined to comment to ABC News on his condition, but asked about him at a news conference on Tuesday, White House press secretary Kayleigh McEnany for the first time publicly acknowledged his battle with the virus.

"Our heart goes out to his family," McEnany said. "They have asked for privacy. And he is recovering, from what I understand. We are very pleased to see that. But he and his family will be in our prayers."

Trump has not publicly commented about Bailey's situation. McEnany said she was "not sure if the president's had a private conversation with him, nor would I confirm any private conversation that he did have."

Bailey's experience with COVID-19 is the most serious publicly reported case linked to the White House.

Trump and several close allies were also hospitalized and received exceptional access to treatment or therapeutics. Among them were the president's personal lawyer, Rudy Giuliani; former New Jersey Gov. Chris Christie, who is also an ABC News contributor; and Ben Carson, the secretary of housing and urban development.

Trump has for months minimized the severity of the virus and its impact on those it sickens. “Remember, when you catch it, you get better, and you’re immune," he said in an interview with Fox Business following his own recovery, which was aided by a world-class medical team and an experimental treatment that had, at the time, only been offered to a handful of people outside of clinical trials. In reality, COVID-19 has killed over 300,000 Americans.

Last week, a White House spokesman did not respond when asked whether Trump had donated, or considered donating, to Bailey. The official on Wednesday declined to comment.

The online fundraiser had raised over $30,000 by last week and more than doubled that total this week after a Monday article by Bloomberg News -- and the mention at McEnany's briefing -- brought more attention to Bailey's situation.

ABC News' Katherine Faulders and John Santucci contributed to this report.
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Postby admin » Fri Dec 25, 2020 5:55 am

‘Subpoenas are necessary’: House watchdog details extensive meddling with CDC Covid-19 reports: New documents show political appointees sought to influence at least 13 reports as they ignored warnings from career officials.
by Dan Diamond
Politico
12/21/2020 10:02 AM EST
Updated: 12/21/2020 11:45 AM EST

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The House panel probing the Trump administration's coronavirus response released new documents detailing political appointees’ extensive efforts to modify or scuttle scientific Centers for Disease Control and Prevention reports, as it also ordered top Trump health officials to quickly provide documents.

Trump appointees attempted to “alter or block” at least 13 scientific reports on the coronavirus as outbreaks surged across the spring and summer, Rep. Jim Clyburn (D-S.C.), the chair of the House select subcommittee on coronavirus, wrote on Monday in a letter that was shared with POLITICO.

"Top political officials at [Health and Human Services] and [the Centers for Disease Control and Prevention] not only tolerated these efforts, but in some cases aided them," Clyburn added in the letter to HHS Secretary Alex Azar and CDC Director Robert Redfield.

Clyburn issued subpoenas to Azar and Redfield, ordering them by Dec. 30 to produce "full and unredacted" documents that Clyburn said his panel has sought for months.


The panel’s probe into administration’s coronavirus response began in mid-September, shortly after a POLITICO story revealed how appointees meddled with the famed Morbidity and Mortality Weekly Reports, which are authored by career scientists and are typically free of political interference. In recent weeks, the panel released evidence alleging that Redfield ordered agency staff to delete an email that appeared to show political interference and that a political adviser repeatedly advocated a controversial “herd immunity” strategy regarded by most public health experts as reckless.

Clyburn's subcommittee on Monday produced dozens of new documents detailing how Trump appointees — including then-science adviser Paul Alexander, the department's top spokesperson Michael Caputo and other health department officials — worked to subvert the CDC's MMWR reports.

Among the MMWRs that were targeted for edits: reports on the use of masks, the spread of Covid-19 in children, the virus' transmission during an April 7 primary election in Milwaukee and other reports that were seen as politically sensitive.

The newly released documents further detailed appointees' extensive efforts to suppress and even write a rebuttal to planned reports on hydroxychloroquine, the malaria drug favored by President Donald Trump as a coronavirus treatment despite little evidence of its effectiveness.
CDC has historically insisted that political appointees not review the draft content of the MMWRs, but in at least one case, Trump appointees obtained the full text of a pending report.

"I got the draft of the WWMR [sic] about hydroxychloroquine and media that was supposed to be released on Tuesday," then-CDC adviser Nina Witkofsky wrote on June 29 to Alexander, Caputo and Caputo's aide Madeleine Hubbard. Witkofsky, who served as a contractor helping plan events for Medicaid chief Seema Verma before joining the Trump administration this summer, was tapped in August to be the CDC's acting chief of staff.

The MMWR on hydroxychloroquine, which reviewed how doctors prescribed the drug, was originally scheduled to be published on June 30 but was not published until Sept. 4.

The reasons for the delay were not immediately clear, but Trump appointees in the meantime further strategized on how to minimize the CDC’s findings – including Alexander’s plans to publicly dismiss the agency’s hydroxychloroquine report. “The authors of this study are a disgrace to public service,” Alexander wrote in a planned rebuttal that does not appear to have been publicly released.

In his letter to HHS, Clyburn said the department continues to block his panel's scheduled interviews with Redfield, CDC principal deputy director Anne Schuchat and Witkofsky, among other officials that HHS previously agreed to make available. HHS also waited until after the election to release its documents, which were mostly pulled from Alexander's files, Clyburn wrote, rather than from officials like Azar and Caputo despite a previous commitment to do so.

"Given the importance of the Select Subcommittee’s investigation and the continued obstruction by HHS, subpoenas are necessary," Clyburn wrote.


Asked about the House panel's findings, HHS said that it had pulled more than 1 million documents for the subcommittee's probe and that Alexander, who has since left the department, did not set strategy.

"While the Administration is focused on vaccination shots, the Subcommittee is focused on cheap shots to create headlines and mislead the American people," said HHS spokesperson Caitlin Oakley.

HHS did not respond to a question about whether the department would comply with the panel's subpoena. CDC did not immediately respond to requests for comment.

Alexander and Witkofsky did not immediately respond to requests for comment. Caputo, who took medical leave the same day that Alexander left the department in September, has referred previous inquiries to HHS.

According to the new documents, Bill Hall, the top career civil servant in the HHS press shop, on June 5 warned Alexander, Caputo and other officials that they should not interfere with the MMWRs, comparing the CDC's flagship reports to a "peer-reviewed journal" akin to the Journal of the American Medical Association.

"[A]s matter of long-standing policy, we do not engage in clearing scientific articles, as that arena needs to remain an independent process," Hall wrote in an email obtained by the subcommittee.

But the subcommittee's documents reveal that political appointees instead kept trying to edit a series of internal and external reports.

"Hi Michael, is this not the article we were shelving?" Alexander wrote to Caputo and Witkofsky on June 29 about a pending CDC-authored report on hydroxychloroquine that was set to run in JAMA. The House panel concluded that Alexander "appeared to mistake" the planned JAMA report for the MMWR report that would be delayed.

The subcommittee also released documents showing how Alexander repeatedly petitioned Charlotte Kent, the MMWR editor-in-chief, to make changes to planned reports, such as an upcoming MMWR on the spread of Covid-19 at a Georgia summer camp amid a robust debate about whether it was safe to reopen schools in the fall. In a separate email chain, CDC career officials discussed how best to navigate the political pressures, and Kent ultimately sent Alexander an email seeking to placate him.

"In response to thoughtful comments from CDC leadership and you, the opening sentence of Georgia’s report has been reframed," Kent wrote to Alexander and other officials on July 28. "The opening sentence was the only reference to schools or institutions of higher learning in the report, and reference to them has been removed."


However, the Georgia summer camp report, which was released on July 31, still angered the health department’s Trump appointees, sparking another effort to author their own response that they believed would be more favorable to the president.

“I am not sure where it can be published but this has very re-assuring information and even for the White House,” Alexander wrote in a planned rebuttal to the report.

HHS has insisted that there was no interference in the MMWRs, pointing to comments from Kent, the reports' editor, who during a Dec. 7 interview with House investigators said that the agency published reports that were scientifically sound.

"Dr. Kent’s interview established there was no political interference in the publication of MMWR Articles," Sarah Arbes, the HHS assistant secretary for legislation, wrote to Clyburn last week.

Clyburn, however, said Kent's testimony made clear there was political pressure to alter her office's reports.

"To the extent career staff were successful in limiting the damage, as Dr. Kent stated she was, that is a testament to the career staff’s integrity and resilience — not an indication that the Trump Administration’s political pressure tactics were appropriate or scientifically sound," Clyburn wrote Monday.

The documents released by Clyburn's panel also further shed light on interactions between Trump appointees and career health department officials as the outbreak worsened. In one exchange, a CDC official complaining about the "pattern of hostile and threatening behavior" from Caputo, the department's top spokesperson who was personally installed by the president.

"In what world did you think it was your job to announce an Administration public service announcement to CNN?” Caputo wrote to a CDC official who confirmed to a CNN reporter in June that the health department was pursuing a vaccine education campaign. Caputo had previously told the reporter she was "wildly incorrect" when she inquired about the campaign.

In another set of July emails, Caputo demanded the name of a CDC press officer who arranged an interview between a senior official and NPR about the health department's data changes without his permission.

After POLITICO obtained emails of Alexander pressuring infectious-disease expert Anthony Fauci to not speak publicly about the risks of Covid-19 to children, Alexander protested to colleagues that he wanted to go public with his complaints about Fauci.

"They have no clue what they are saying and I welcome the chance to inform them," Alexander wrote on Sept. 9. HHS announced that Alexander, who is a part-time professor at a Canadian university, would exit the department a week later.
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Re: U.S. government gave $3.7 million grant to Wuhan lab at

Postby admin » Fri Dec 25, 2020 6:18 am

Health Officials Subpoenaed in Probe of Political Interference at CDC
by Brad Kutner
Courthouse News Service
December 21, 2020

WASHINGTON (CN) — The Democratic leader of a House panel overseeing the federal government’s response to the Covid-19 pandemic said Monday that Trump administration health officials tried to bury alarming information in scientific reports on the outbreak.

Congressman Jim Clyburn, a South Carolina Democrat who chairs the House Select Subcommittee on the Coronavirus Crisis, said in a letter that he has subpoenaed Health and Human Services Secretary Alex Azar and Robert Redfield, director of the Centers for Disease Control and Prevention.

Clyburn wants to get unredacted documents that he says show efforts by appointees of President Donald Trump to “block or alter” over a dozen CDC reports on the pandemic and hydroxychloroquine, a drug the president touted for months as a possible treatment despite a lack of medical evidence.

“These appointees targeted reports that provided evidence of the virus’s ‘early spread’ across the country and ‘massive spread’ this summer, which they believed sent ‘the wrong message’ about the Administration’s policies,” the letter states. “These appointees also drafted rebuttals aimed at undercutting CDC’s credibility and providing ‘very re-assuring information … for the White House.’”

One of the draft rebuttals, which was never published, reportedly attacked a CDC report on an increase in prescriptions for hydroxychloroquine after the drug’s emergency use authorization was revoked based on findings of potential harms outweighing the benefits. According to the letter, the rebuttal drafted by HHS officials stated that the hydroxychloroquine report “presents factual information with an agenda” and could “prevent the news from giving the proper coverage of a true ‘miracle cure.’”

Clyburn said the subpoenas come after three months of obstruction by the administration and evidence showing Redfield ordered subordinates to delete an email about a report on the risk of Covid-19 to children.

“Top political officials at HHS and CDC not only tolerated these efforts, but in some cases aided them
—even after a senior career official warned that CDC’s scientific writing ‘needs to remain an independent process’ and that the administration’s attempts to influence these reports violated ‘long-standing policy,’” the letter states.

The 20-page letter cites several internal documents obtained by the House committee, including communications between CDC members over a report on an outbreak at a Georgia summer camp that showed “massive spread” at the facility while the White House was touting a plan to reopen schools.

“I find it incredible this piece would be put out the way it is written at a time when CDC and its leader Dr. Redfield is trying to showcase the school re-open guidance and the push is to help schools re-open safely,” Paul Alexander wrote in a July email obtained by the committee. “It just sends the wrong message as written and actually reads as if to send a message of not to re-open.”

Alexander joined the Department Health and Human Services in April but has since been let go. According to a Politico report, he spent much of his short tenure advocating for herd immunity, which would require most Americans to get infected by the virus. Experts estimate that strategy would lead to 1 to 2 million deaths.

“There is no other way, we need to establish herd, and it only comes about allowing the non-high risk groups expose themselves to the virus. PERIOD,” Alexander wrote in a different July email obtained by Politico.
Despite Alexander’s push, Azar told Congress in October that “herd immunity is not the strategy of the U.S. government with regard to coronavirus.”

Clyburn’s committee also seeks to explore claims that staff scientists were bullied after they shared information the Trump administration did not want spread.

“If you disobey my directions, you will be held accountable,” HHS Assistant Secretary for Public Affairs Michael R. Caputo wrote in a July email warning several communications staffers after CDC epidemiologist Daniel Pollock did an interview with NPR in which he was critical of a White House policy telling hospitals to bypass the CDC and send its Covid-19 data to a different database.

The subpoenas have a document turnover deadline of Dec. 30.

CDC and HHS officials, as well as Republican members of the coronavirus committee, did not immediately respond to requests for comment.
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Re: U.S. government gave $3.7 million grant to Wuhan lab at

Postby admin » Fri Dec 25, 2020 6:57 am

Part 1 of 2

Letter from Select Subcommittee on the Coronavirus Crisis, James E. Clyburn, Chairman, to The Hon. Alex M. Azar, II, Secretary, Department of Health and Human Services and Dr. Robert R. Redfield, Director, Centers for Disease Control and Prevention
December 21, 2020

One Hundred Sixteenth Congress
Congress of the United States
House of Representatives
Select Subcommittee on the Coronavirus Crisis
2157 Rayburn House Office Building
Washington, DC 20515-6143
Phone (202) 22504400
https://coronavirus.house.gov

James E. Clyburn, Chairman
Maxine Waters
Carolyn B. Maloney
Nydia M. Velazquez
Bill Foster
Jamie Raskin
Andy Kim
Steve Scalise, Ranking Member
Jim Jordan
Blaine Luetkemeyer
Jackie Walorski
Mary E. Green, M.D.

December 21, 2020

The Honorable Alex M. Azar II
Secretary
Department of Health and Human Services
200 Independence Avenue,
S.W. Washington, D.C. 20201

Dr. Robert R. Redfield
Director
Centers for Disease Control and Prevention
395 E Street, S.W., Suite 9100
Washington, D.C. 20201

Dear Secretary Azar and Director Redfield:

The Select Subcommittee on the Coronavirus Crisis issued subpoenas today compelling you to produce all of the documents requested by the Select Subcommittee on September 14, 2020, relating to efforts by political appointees at the Department of Health and Human Services (HHS) to interfere with scientific work conducted by career officials at the Centers for Disease Control and Prevention (CDC). The subpoenas require you to produce a full and unredacted set of these documents by December 30, 2020.

The subpoenas were necessary because the Select Subcommittee’s investigation has revealed that efforts to interfere with scientific work at CDC were far more extensive and dangerous than previously known. Documents recently obtained by the Subcommittee show that over a period of four months, as coronavirus cases and deaths rose around the country, Trump Administration appointees attempted to alter or block at least 13 scientific reports related to the virus. These appointees targeted reports that provided evidence of the virus’s “early spread” across the country and “massive spread” this summer, which they believed sent “the wrong message” about the Administration’s policies. These appointees also drafted rebuttals aimed at undercutting CDC’s credibility and providing “very re-assuring information … for the White House.” Top political officials at HHS and CDC not only tolerated these efforts, but in some cases aided them—even after a senior career official warned that CDC’s scientific writing “needs to remain an independent process” and that the Administration’s attempts to influence these reports violated “long-standing policy.”

Documents show that HHS officials also attempted to muzzle CDC scientists by retaliating against career employees who provided truthful information to the public and targeting CDC staff with what one employee described as a “pattern of hostile and threatening behavior.”

These unprecedented efforts to influence CDC’s reports and bully its staff occurred at the same time HHS officials were privately advocating for a “herd immunity” strategy to spread the coronavirus widely among Americans
, as the Select Subcommittee revealed in a December 16, 2020, staff memorandum.1 The Select Subcommittee needs to obtain all the documents sought in its September 14 request to understand who in the Trump Administration was responsible for this political pressure campaign, whether it was intended to cripple the nation’s coronavirus response in a misguided effort to achieve herd immunity, and what steps must be taken to end this outrageous conduct and protect American lives.

HHS has made clear that it will not provide a timely and complete response to the Select Subcommittee’s requests on a voluntary basis. Although the Select Subcommittee has made extensive efforts to obtain cooperation over the last three months, HHS continues to withhold responsive documents related to senior HHS and CDC officials. Evidence obtained by the Select Subcommittee last week indicates that Director Robert Redfield instructed employees to destroy a key document in the Select Subcommittee’s investigation, raising the possibility that other evidence may have been hidden or destroyed. HHS is also blocking the Select Subcommittee from interviewing five key witnesses, including Director Redfield, his principal deputy, and his acting chief of staff.2 For these reasons and those set forth below, the Select Subcommittee had no choice but to issue subpoenas compelling production of documents that have been withheld by HHS and CDC since September.

I. THE ADMINISTRATION’S CAMPAIGN TO INTERFERE IN CDC SCIENTIFIC REPORTS WAS MORE EXTENSIVE AND DANGEROUS THAN PREVIOUSLY KNOWN

Spearheaded by HHS Assistant Secretary for Public Affairs Michael Caputo and his Senior Advisor, Paul Alexander, efforts to influence or block CDC’s Morbidity and Mortality Weekly Report (MMWR) and other scientific publications went on for months and involved numerous high-level officials at CDC and HHS.

In a December 7, 2020, transcribed interview with Select Subcommittee staff, MMWR Editor-in-Chief Charlotte Kent confirmed that Dr. Alexander contacted her directly on numerous occasions to pressure her to make changes to MMWRs and to seek a larger role in the review process, in violation of longtime CDC and HHS policy to maintain the independence of these reports. She said she “felt it was important to respond” to his demands, but said that Dr. Alexander’s efforts, if successful, would have impacted the integrity of CDC’s scientific work. She explained, “if we chose to collaborate with Dr. Alexander, there could be a perception that that was influencing the scientific integrity of MMWR, and that was something that we were not going to do.”3

HHS has falsely claimed that Dr. Kent’s testimony shows that there was no political interference with MMWRs.4 To the contrary, as demonstrated by the transcript, Dr. Kent stated that she was “surprised” that Dr. Alexander sought to make changes to MMWRs, that his efforts were “not typical,” and that she raised the issue to her superiors’ attention “because it was an unusual situation.”5 Dr. Kent’s testimony and documents obtained by the Select Subcommittee show that she and other career officials were forced to fend off more than a dozen attempts to influence CDC’s scientific publications, and in some cases were instructed to make changes recommended by political officials. To the extent career staff were successful in limiting the damage, as Dr. Kent stated she was, that is a testament to the career staff’s integrity and resilience—not an indication that the Trump Administration’s political pressure tactics were appropriate or scientifically sound.

Former CDC Chief of Staff Kyle McGowan, who was at CDC when this pressure campaign began, recently confirmed that HHS appointees attempted to interfere in the publication of MMWRs, saying that Dr. Alexander “absolutely put pressure on the CDC on different guidance documents, on MMWRs,” and that these efforts “delayed MMWRs from getting them out as quickly as possible to be effective.”6

A. Despite Warning from Career Staff, HHS Attempted to Interfere with More than 12 Coronavirus Reports from May to September 2020

Documents reveal that efforts by HHS officials to interfere in CDC scientific reports, with the apparent goal of helping President Trump politically, began in May 2020 and continued through mid-September—despite an early warning from a career official that these actions violated longstanding policies intended to protect the scientific independence of CDC reports.

On May 22, 2020, Dr. Alexander wrote to HHS Deputy Assistant Secretary Bill Hall, the top career official in HHS’s Public Affairs Office, requesting that CDC alter the title and contents of an upcoming MMWR, entitled, “Evidence for Early Spread of COVID-19 Within the United States, January – February 2020.” Dr. Alexander explained that he had discussed the matter with Mr. Caputo and wanted to insert language praising what he called the Administration’s “[s]trong mitigation and containment measures.” He also asked to revise the report’s title, which he claimed was “misleading and little inflamming [sic]” because it indicated that “COVID was in US prior to when it was first detected etc.”7 Ultimately, CDC did not add the reference to the Administration’s actions but did change the report’s title in a manner that downplayed the report’s key finding. The revised title was: “Evidence of Limited Early Spread of COVID-19 Within the United States, January–February 2020.”8

On June 5, 2020, Dr. Alexander wrote to Mr. Caputo, Mr. Hall, and other HHS officials seeking to insert language into another CDC study related to coronavirus prevention. Mr. Hall wrote back:

The MMWR is a peer-reviewed journal no different than, say, JAMA or NEJM, and, like those journals, the text of articles is negotiated between the submitting authors and the MMWR editorial team. The article has already been published and been distributed. [The Office of the Assistant Secretary for Public Affairs] is not a science or medical program office and, as matter of long-standing policy, we do not engage in clearing scientific articles, as that arena needs to remain an independent process.9


Despite receiving this admonishment from a senior career official, Dr. Alexander began reaching out to CDC officials directly, attempting to alter the contents of at least 11 other scientific reports, including the following:

• A July 3 MMWR regarding characteristics of adult inpatients and outpatients with coronavirus;10

• An MMWR regarding hydroxychloroquine prescription trends, originally scheduled for release on June 30 but not published until September 4;11

• A July 14 MMWR on the use of cloth face coverings among adults during the pandemic;12

• A July 24 MMWR regarding underlying medical conditions associated with the risk of severe COVID-19;13

• A July 31 MMWR regarding efforts to mitigate coronavirus transmission during the April 7 primary election in Milwaukee, Wisconsin;14

• A July 31 MMWR regarding vaccination among children in New York City during the pandemic;15

• An MMWR scheduled for early release on July 29 regarding a coronavirus outbreak among children attending an overnight summer camp in Georgia, which was delayed until after Director Redfield testified before the Select Subcommittee;16

• An August 14 MMWR, originally scheduled for release on August 7, regarding hospitalization rates for children diagnosed with the coronavirus;17

• An August 14 MMWR, originally scheduled for release on August 7, regarding multi-inflammatory syndrome in children with coronavirus;18

• A September 4 MMWR regarding coronavirus outbreaks at four summer camps in Maine; and19

• A September 18 MMWR on coronavirus-associated deaths among children, adolescents, and young adults.20


Hydroxychloroquine Report

On June 29, 2020, Director Redfield’s Senior Advisor Nina Witkofsky obtained a copy of a planned June 30 MMWR on hydroxychloroquine and provided it to Mr. Caputo and Dr. Alexander.21 The CDC study found that hydroxychloroquine prescriptions increased 80-fold between March 2019 and March 2020.22 Hydroxychloroquine—which President Trump lauded as a “miracle” treatment for the coronavirus—received Emergency Use Authorization by the Food and Drug Administration to treat coronavirus in March 2020, but this authorization was revoked in June after it was determined that the potential harms of the drug outweighed the benefits.23

Less than an hour after he received a copy of this MMWR, Dr. Alexander sent an email to Mr. Caputo and Ms. Witkofsky, saying, “Hi Michael, is this not the article we were shelving?”24 The following day, a staffer in Mr. Caputo’s office wrote to Ms. Witkofsky, copying Dr. Alexander, making clear that political officials intended to make changes to the MMWR:


I am reviewing the MMWR on hydroxychloroquine you sent to Michael yesterday. There are quite a few edits on it. I forwarded that Word Document to Paul who is going to look over the MMWR. If you could please keep Dr. Paul Alexander, who is CC’d here, and myself in the loop on this MMWR, it would be much appreciated.25


HHS officials went so far as to draft a rebuttal attacking this MMWR. This document—which does not appear to have been published—argued erroneously that the MMWR “presents factual information with an agenda” and could “prevent the news from giving the proper coverage of a true ‘miracle cure.’” The rebuttal also asserted that “there is no academic value in this study whatsoever.”26 The op-ed called the authors of the MMWR “a disgrace to public service” and accused them of being “self-aggrandizing, looking to grab headlines” and “ignoring and [sic] the Americans currently dying from COVID-19.”27 When asked about this rebuttal document during her interview, Dr. Kent stated that she was not aware of it at the time but that the rebuttal “could undermine confidence in CDC and in the quality of science that is in MMWR.”28 The MMWR, originally scheduled for release on June 30, was published on September 4.29 It is not clear whether the final report included edits from HHS.

Report on Outbreak at Georgia Summer Camp

On July 26, 2020, Dr. Kent circulated a summary of a draft report on a coronavirus outbreak at a Georgia summer camp to a group of HHS and CDC officials. Dr. Alexander responded hours later with an eight-point list of questions and comments, asserting that the report would undermine the Administration’s push to quickly reopen schools. He wrote:

This CDC MMWR also concluded by saying in spite of adhering to CDC guidance, the spread was massive, with elevated attack rates. … This confuses me because you, in fact, are CDC and the piece reads as if CDC’s own guidance is not adequate and that even if a school or similar implements most recommended strategies to prevent transmission, that there will still be massive spread. I find it incredible this piece would be put out the way it is written at a time when CDC and its leader Dr. Redfield is trying to showcase the school re-open guidance and the push is to help schools re-open safely. It just sends the wrong message as written and actually reads as if to send a message of NOT to re-open.30


The following morning, on July 27, HHS officials asked to see a full copy of the report.31 Later that day, CDC Principal Deputy Director Anne Schuchat instructed Dr. Kent to remove the opening sentence of the abstract, which stated that understanding transmission of the virus among children “is critical for developing guidance for schools and institutes of higher education.”32

The revised abstract eliminated this reference to schools and colleges, replacing it with a sentence asserting that “[l]imited data are available about transmission” of the coronavirus among youth. In an email to Dr. Alexander, copying Director Redfield and others, Dr. Kent explained:

In response to thoughtful comments from CDC leadership and you, the opening sentence of Georgia’s report has been reframed. The opening sentence was the only reference to schools or institutions of higher learning in the report, and reference to them has been removed.33


Director Redfield also inserted two changes to the MMWR, although HHS has not provided the Select Subcommittee with documentation of these changes.34

The initial release of the MMWR, originally set for July 29, was delayed to July 31 at the direction of Director Redfield and HHS.35 Dr. Kent informed the Select Subcommittee that she understood this delay was due to Director Redfield’s scheduled testimony before the Select Subcommittee on the morning of July 31, adding that “there were some very important things that they wanted to convey during that meeting.”36 At the July 31 hearing, Director Redfield testified of the “very significant public health consequences of the school closure,” but did not discuss the CDC study, which found that the virus spread widely among children at the Georgia summer camp.37

At the same time they sought to influence the text of the MMWR, HHS officials also coordinated to rebut the report’s key finding that children can transmit the virus to each other and to adults. On July 27, Dr. Alexander wrote to Mr. Caputo, Ms. Witkofsky, and HHS Senior Advisor Brad Traverse regarding a rebuttal piece he was asked to draft:

Hi Michael, as requested, here is the piece to rebut that poor CDC MMWR…I am not sure where it can be published but this has very re-assuring information and even for the White House. You can now tweak this how you wish.38


The op-ed, which went through several drafts at HHS but does not appear to have been published, sought to downplay the risk of children transmitting the coronavirus and reaffirm the Administration’s position that schools should quickly and fully reopen.39

HHS’s attacks on this MMWR continued the following week. On August 8, 2020, Dr. Alexander demanded that Director Redfield and Mr. Caputo intervene to alter this report, along with a second MMWR, or stop the publication of all MMWRs.40 As described in my December 10, letter, Dr. Kent told the Select Subcommittee she was ordered to delete this email, and that she understood the direction to delete the email came from Director Redfield.41

Although Director Redfield did not accede to Dr. Alexander’s demand to alter the report or halt publication of all MMWRs, Dr. Alexander continued to reach out to Dr. Kent seeking to influence other MMWRs following this incident.42

B. Assistant Secretary for Public Affairs Attempted to Retaliate Against CDC Officials

Evidence obtained by the Select Subcommittee shows that Mr. Caputo aggressively bullied and retaliated against CDC staff who provided truthful information to the press without his permission and that Director Redfield was aware of this behavior.

Retaliation for Revealing Advertising Campaign

In June 2020, a CNN reporter wrote to Mr. Caputo, asking whether “Operation Warp Speed is working on a vaccine education campaign.” Mr. Caputo refused to confirm the story, claiming it was “wildly incorrect.” The reporter then followed up, noting that a career CDC official had referred her to Mr. Caputo and indicated that Mr. Caputo himself was “spearheading” the campaign.43

Mr. Caputo then excoriated the career official for providing truthful information to CNN, writing, “In what world did you think it was your job to announce an Administration public service announcement to CNN?” He later followed up, stating, “We will discuss this on a teleconference tomorrow. I want your HR representative in attendance.” Mr. Caputo added Director Redfield to the exchange, writing, “I’m adding Dr Redfield back in this email exchange. Do not remove him again.”44

Retaliation for Discussing Removal of Hospital Data Collection from CDC

In July 2020, a senior CDC scientist was interviewed by NPR about the Administration’s decision to strip CDC of its longstanding role in collecting hospital data—which experts warned could cause researchers, reporters, and the public to lose access to crucial data needed to combat the pandemic. The scientist, Dr. Daniel Pollock, explained in the interview that CDC had a successful “track record” and “expertise” in collecting this data.45

When Mr. Caputo learned the interview occurred without his personal permission, he called the action “reckless,” and demanded to know the name of the CDC press officer who arranged it, warning CDC’s senior staff: “If you disobey my directions, you will be held accountable.”
Following Mr. Caputo’s outburst, CDC Deputy Communications Director Kate Galatas informed Mr. Caputo that the incident was caused by a mistake and that CDC was planning to issue the employee a “formal letter of reprimand.” She then sought assistance from Director Redfield and his Chief of Staff for assistance in handling Mr. Caputo’s demands, stating: “Please intervene and have someone else at CDC send the appropriate program person’s name to Mr. Caputo … I respectively request that you not require me to do so.” 46

Ms. Galatas also wrote to HHS’s Deputy Chief Counsel about Mr. Caputo’s conduct, saying, “I see this as a pattern of hostile and threatening behavior directed at me, Michelle [Bonds, Director of CDC’s Division of Public Affairs], and communication staff at CDC.”47

C. Senior Administration Officials Allowed Dangerous Interference by Mr. Caputo and Dr. Alexander to Continue Until it Became Public

Although HHS and CDC officials have recently tried to distance themselves from Mr. Caputo and Dr. Alexander, emails show Trump Administration officials were aware of their conduct for months but took no action until the press became aware of this behavior and the Select Subcommittee launched an investigation.

For example, Ms. Witkofsky—a top advisor to Director Redfield who became Acting Chief of Staff in August 2020—worked closely with Mr. Caputo and Dr. Alexander beginning in June 2020 to facilitate their efforts to obtain and review MMWRs prior to their release.48 Both Director Redfield and Ms. Witkofsky were copied on multiple emails in which Dr. Alexander attempted to alter MMWRs and Mr. Caputo bullied CDC career staff.49

However, no action was taken against Mr. Caputo and Dr. Alexander until their disgraceful conduct became public. On September 9, 2020, a reporter from Politico reached out to HHS seeking comment on concerns regarding Dr. Alexander.50 Two days later, on September 11, Ms. Witkofsky directed Dr. Kent to remove Dr. Alexander—but not Mr. Caputo—from the distribution list for MMWR summaries.51 That same day, Politico published an article revealing publicly for the first time that Dr. Alexander had tried to change and block MMWRs.52

On September 14, the Select Subcommittee launched this investigation and requested to interview both Mr. Caputo and Dr. Alexander, among others, the following week. Two days later, on September 16, the Department announced that both officials would leave their roles, with Mr. Caputo taking a leave of absence and Dr. Alexander exiting the Department entirely.53

II. TRUMP ADMINISTRATION’S REFUSAL TO COOPERATE

As explained in my December 10, 2020, letter to you, the Select Subcommittee launched this investigation more than three months ago, yet HHS has repeatedly refused to provide key documents and witnesses that the Select Subcommittee needs to complete its inquiry.

A. Refusal to Voluntarily Produce Documents and Witnesses

The Select Subcommittee’s September 14, 2020, letter requested transcribed interviews with seven HHS and CDC officials beginning on September 22, and the production of documents on September 28.54

On September 18, HHS responded, claiming the Select Subcommittee’s requests were “pretextual”
and demanding “additional clarity” on how the request “satisfies the requirement that oversight inquiries be conducted pursuant to a valid legislative purpose.”55

pretextual: constituting a pretext; dubious or spurious; denoting or relating to a minor offense that enables authorities to detain a suspect for investigation of other matters.


The Select Subcommittee responded on September 22, explaining that the Select Subcommittee’s investigation is clearly authorized by House Resolution 935, that ensuring Americans have access to accurate public health information during the pandemic is an issue that is amenable to legislation, and that evidence of ongoing political interference at HHS made the investigation even more urgent.56

HHS wrote back on September 25, claiming again that the Select Subcommittee’s requests were “pretextual” and demanding answers to a list of logistical questions.
57 Select Subcommittee staff responded to HHS’s questions by email and asked the Department to confirm dates for the interviews.58 In response, HHS staff claimed on September 28 that the Department was “assessing witness availability to sit and prepare for interviews.”59 On October 2, Secretary Azar confirmed in sworn testimony before the Select Subcommittee that HHS would soon make documents and witnesses available, stating:

Our staffs are working to secure the agreements on the procedures to make that happen. We want to make that happen. … I think they’re in the final stages of getting things arranged.60


However, instead of moving forward with interview arrangements or document production, HHS staff sent an email to Select Subcommittee staff on October 7 with a series of new demands, stating, “Until these outstanding issues and processes are resolved, it is not appropriate to commit to specific dates for interviews.” HHS staff also indicated that the Department planned to withhold responsive documents from the Select Subcommittee, writing that HHS “will be conducting document searches and reviewing responsive materials” in advance of any interviews but “these document pulls are solely for the Department’s use,” and stating, “The Subcommittee should not expect to receive any documents before the transcribed interviews occur.”61 Select Subcommittee staff asked HHS to confirm dates for interviews and a schedule for document production on October 14 and October 21, but HHS refused.

B. Inadequate Document Production Following Subpoena Warning

On October 22, 2020, the Select Subcommittee wrote to HHS, warning that if the Department did not voluntarily comply, the Select Subcommittee would be forced to consider issuing subpoenas.62 On October 27, HHS responded, again questioning the premise of the Select Subcommittee’s investigation and refusing to commit to a production schedule.63 After further negotiation, HHS agreed on October 29 to make five witnesses available for transcribed interviews—excluding Mr. Caputo and Dr. Alexander, who were no longer serving in their previous roles—and to make a full document production by November 23, writing:

HHS will target November 9 for a complete production of documents for the five named custodians, as well as others whom we have identified to date. … We will also commit to target November 23 for a complete production for the remaining political appointees.64


HHS did not meet the agreed upon production schedule. Instead, the Department slowly produced a fraction of the requested documents, along with thousands of pages of repetitive, non-responsive, and redacted materials. For example:

• HHS agreed to produce documents from Mr. Azar, Director Redfield, Mr. Caputo, Dr. Alexander, and Mr. Traverse by November 9, but the Department’s actual productions have included a substantial production of emails from just one of these five custodians—Dr. Alexander.

Although HHS has produced just over 15,000 pages, thousands of these pages consist of duplicative copies of public reports and documents that are entirely non-responsive—including some that are more than a year old and predated the coronavirus pandemic entirely.65

• Dozens of pages are entirely redacted and marked “withheld as privileged”—without any indication of the basis for the redaction or the privilege being asserted. In one instance, HHS completely redacted more than 50 consecutive pages without any further explanation.
66

HHS has refused to agree to any timeframe to complete its production, notwithstanding the Department’s previous commitment to produce all documents by November 23.

C. Abrupt Cancellation of Interviews Following Troubling Testimony by Career Official

HHS further obstructed the Select Subcommittee’s inquiries by abruptly canceling four transcribed interviews the Department had previously agreed to conduct during the week of December 7, 2020. HHS canceled these interviews just hours after Dr. Kent revealed in her interview that Director Redfield may have ordered staff to delete key evidence of political interference.67

The Department claimed that it canceled these interviews because Select Subcommittee counsel infringed upon the attorney-client privilege by asking Dr. Kent whether, in addition to being instructed to delete a key email, she was instructed to withhold any other information from Congress. This claim has no basis whatsoever. Given the clear evidence that CDC officials were instructed to delete evidence, the Select Subcommittee has a strong interest in determining whether anyone at HHS or CDC ordered staff to obstruct this investigation. Such obstruction is potentially illegal and is not protected by any privilege.68


D. Final Warning Letter and HHS’s Refusal to Comply

On December 10, 2020, I wrote to both of you requesting full compliance with the Select Subcommittee’s outstanding document requests by December 15, and warned that if you did not comply, I would have no choice but to issue subpoenas to obtain the remaining documents.69 The letter also asked you to reschedule the four canceled interviews. Finally, in light of the new evidence that Director Redfield ordered CDC officials to destroy evidence of political interference, the letter requested additional documents by December 15 and a transcribed interview with Director Redfield on December 17.

These deadlines have now passed, and HHS did not comply with any of the Select Subcommittee’s requests. The Department’s document production remains woefully incomplete. The Department has not rescheduled any of the canceled interviews with senior CDC officials.

HHS also refused to make Director Redfield available for a transcribed interview, claiming that “an interview of Dr. Redfield is not warranted at this time.”70 Notably, however, HHS did not refute Dr. Kent’s statements that she was instructed to delete a key email, that she understood the instruction came from Director Redfield, and that the email was in fact deleted from her inbox by another individual. HHS also did not address the critical questions of whether Director Redfield or other political appointees ordered other staff at CDC or HHS to delete or conceal evidence of political interference. These are critical questions, and the Select Subcommittee intends to get answers.

III. ISSUANCE OF SUBPOENA

HHS and CDC have indicated their unwillingness to voluntarily cooperate with the Select Subcommittee’s investigation. Given the importance of the Select Subcommittee’s investigation and the continued obstruction by HHS, subpoenas are necessary.

The Select Subcommittee has a broad mandate to investigate “issues related to the coronavirus crisis,” including the “preparedness for and response to the coronavirus crisis,” “executive branch policies, deliberations, decisions, activities, and internal and external communications related to the coronavirus crisis,” and “cooperation by the executive branch” with the Select Subcommittee’s oversight. Political interference in scientific work necessary to respond to the coronavirus crisis is central to the Select Subcommittee’s mandate and could be the subject of legislation.

As the Supreme Court has recognized, “The congressional power to obtain information is ‘broad’ and ‘indispensable.’”71 The Court has also recognized that the “scope of the power of inquiry, in short, is as penetrating and far-reaching as the potential power to enact and appropriate under the Constitution.”72

For the reasons described in this letter, I have issued subpoenas to both of you to compel production of all the documents that were first requested by the Select Subcommittee on September 14, 2020. The subpoenas, which were shared with the Ranking Member more than 48 hours ago, require you to produce a full and unredacted set of these documents by December 30, 2020.

Please note that the Select Subcommittee also expects you to provide a complete response to the requests in our December 10, 2020, letter. If you fail do so, additional subpoenas may be necessary.

Sincerely,

__________________________
James E. Clyburn
Chairman
 
cc: The Honorable Steve Scalise, Ranking Member
admin
Site Admin
 
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Re: U.S. government gave $3.7 million grant to Wuhan lab at

Postby admin » Fri Dec 25, 2020 6:58 am

Part 2 of 2

_______________

Notes:

1 Memorandum from Majority Staff to Members, Select Subcommittee on the Coronavirus Crisis, Supplemental Memorandum on Investigation into Political Interference with Coronavirus Response (Dec. 16, 2020) (online at https://coronavirus.house.gov/sites/dem ... munity.pdf).

2 Select Subcommittee on the Coronavirus Crisis, Press Release: Select Subcommittee Investigation Finds Evidence Career CDC Officials Were Directed to Destroy Record of Political Interference by Trump Administration (Dec. 10, 2020) (online at https://coronavirus.house.gov/news/pres ... cials-were).
 
3 Transcribed Interview of Charlotte Kent (Dec. 7, 2020) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf) at 651 – 654, 1619 – 1622.

4 Letter from Sarah C. Arbes, Assistant Secretary for Legislation, Department of Health and Human Services, to Chairman James E. Clyburn, Select Subcommittee on the Coronavirus Crisis (Dec. 15, 2020) (online at https://coronavirus.house.gov/sites/dem ... 201215.pdf).

5 Transcribed Interview of Charlotte Kent (Dec. 7, 2020) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf) at 648 – 654, 1460 – 1463, 1503 – 1518, 1551 – 1572; see also id. at 1792 – 1803.

6 ‘We Want Them Infected’: Trump Appointee Demanded ‘Herd Immunity’ Strategy, Emails Reveal, Politico (Dec. 16, 2020) (online at http://www.politico.com/news/2020/12/16 ... egy-446408).

7 Email from Paul Alexander, Senior Advisor, Department of Health and Human Services, to Bill Hall, Deputy Assistant Secretary for Public Affairs, Department of Health and Human Services (May 22, 2020) (SSCC-008869 – 71) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

8 Dr. Michelle A. Jorden, et al., Evidence for Limited Early Spread of COVID-19 Within the United States, January–February 2020, Morbidity and Mortality Weekly Report (June 5, 2020) (online at http://www.cdc.gov/mmwr/volumes/69/wr/mm6922e1.htm) (emphasis added).

9 Email from Bill Hall, Deputy Assistant Secretary for Public Affairs, Department of Health and Human Services to Paul Alexander, Senior Advisor, Department of Health and Human Services, et al. (June 5, 2020) (SSCC-0007790 – 92) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf) (emphasis added).

10 Dr. Mark Tenforde, et al., Characteristics of Adult Outpatients and Inpatients with COVID-19 — 11 Academic Medical Centers, United States, March–May 2020, Morbidity and Mortality Weekly Report (July 3, 2020) (online at http://www.cdc.gov/mmwr/volumes/69/wr/mm6926e3.htm); Email from Charlotte Kent, Chief of the Scientific Publications Branch, Centers for Disease Control and Prevention, to Paul Alexander, Senior Advisor, Department of Health and Human Services (June 22, 2020) (SSCCManual-000106 – 09) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

11 Dr. Lara Bull-Otterson, et al., Hydroxychloroquine and Chloroquine Prescribing Patterns by Provider Specialty Following Initial Reports of Potential Benefit for COVID-19 Treatment — United States, January–June 2020, Morbidity and Mortality Weekly Report (Sept. 4, 2020) (online at http://www.cdc.gov/mmwr/volumes/69/wr/mm6935a4.htm); Email from Paul Alexander, Senior Advisor, Department of Health and Human Services, to Nina Witkofsky, Senior Advisor, Centers for Disease Control and Prevention, and Michael Caputo, Assistant Secretary for Public Affairs, Department of Health and Human Services (June 29, 2020) (SSCC-0007294 – 305) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

12 Dr. Kiva A. Fischer, et al., Factors Associated with Cloth Face Covering Use Among Adults During the COVID-19 Pandemic — United States, April and May 2020, Morbidity and Mortality Weekly Report (July 17, 2020) (online at http://www.cdc.gov/mmwr/volumes/69/wr/mm6928e3.htm); Email from Paul Alexander, Senior Advisor, Department of Health and Human Services, to Charlotte Kent, Chief of the Scientific Publications Branch, Centers for Disease Control and Prevention, et al. (July 14, 2020) (SSCC-0006018 – 24) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

13 Hilda Razzaghi, et al., Estimated County-Level Prevalence of Selected Underlying Medical Conditions Associated with Increased Risk for Severe COVID-19 Illness — United States, 2018, Morbidity and Mortality Weekly Report (July 24, 2020) (online at http://www.cdc.gov/mmwr/volumes/69/wr/mm6929a1.htm); Email from Charlotte Kent, Chief of the Scientific Publications Branch, Centers for Disease Control and Prevention, to Paul Alexander, Senior Advisor, Department of Health and Human Services, et al. (July 21, 2020) (SSCCManual-000094 – 97) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

14 Dr. Heather Paradis, et al., Notes from the Field: Public Health Efforts to Mitigate COVID-19 Transmission During the April 7, 2020 Election ― City of Milwaukee, Wisconsin, March 13–May 5, 2020, Morbidity and Mortality Weekly Report (July 31, 2020), Morbidity and Mortality Weekly Report (online at http://www.cdc.gov/mmwr/volumes/69/wr/mm6930a4.htm); Email from Paul Alexander, Senior Advisor, Department of Health and Human Services, to Charlotte Kent, Chief of the Scientific Publications Branch, Centers for Disease Control and Prevention (July 27, 2020) (SSCC-0005359 – 63) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

15 Marisa Langdon-Embry, et al., Notes from the Field: Rebound in Routine Childhood Vaccine Administration Following Decline During the COVID-19 Pandemic — New York City, March 1–June 27, 2020, Morbidity and Mortality Weekly Report (July 31, 2020) (online at http://www.cdc.gov/mmwr/volumes/69/wr/mm6930a3.htm); Email from Paul Alexander, Senior Advisor, Department of Health and Human Services, to Charlotte Kent, Chief of the Scientific Publications Branch, Centers for Disease Control and Prevention (July 27, 2020) (SSCC-0005359 – 63) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

16 Christine M. Szablewski, et al., SARS-CoV-2 Transmission and Infection Among Attendees of an Overnight Camp — Georgia, June 2020, Morbidity and Mortality Weekly Report (Aug. 7, 2020) (online at http://www.cdc.gov/mmwr/volumes/69/wr/mm6931e1.htm); Email from Charlotte Kent, Chief of the Scientific Publications Branch, Centers for Disease Control and Prevention, to Paul Alexander, Senior Advisor, Department of Health and Human Services, et al. (July 28, 2020) (SSCC-0002881 – 88) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf); Transcribed Interview of Charlotte Kent (Dec. 7, 2020) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf) at 1256 – 1259, 1283 – 1305.

17 Dr. Lindsay Kim, et al., Hospitalization Rates and Characteristics of Children Aged <18 Years Hospitalized with Laboratory-Confirmed COVID-19 — COVID-NET, 14 States, March 1–July 25, 2020, Morbidity and Mortality Weekly Report (Aug. 14, 2020) (online at http://www.cdc.gov/mmwr/volumes/69/wr/mm6932e3.htm); Email from Charlotte Kent, Chief of the Scientific Publications Branch, Centers for Disease Control and Prevention, to Paul Alexander, Senior Advisor, Department of Health and Human Services, et al. (Aug. 6, 2020) (SSCCManual-000032 – 38) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

18 Dr. Shana Godfred-Cato, et al., COVID-19–Associated Multisystem Inflammatory Syndrome in Children — United States, March–July 2020, Morbidity and Mortality Weekly Report (Aug. 14, 2020) (online at http://www.cdc.gov/mmwr/volumes/69/wr/mm6932e2.htm); Email from Charlotte Kent, Chief of the Scientific Publications Branch, Centers for Disease Control and Prevention, to Paul Alexander, Senior Advisor, Department of Health and Human Services, et al. (Aug. 6, 2020) (SSCCManual-000032 – 38) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

19 Dr. Laura L. Blaisdell, et al., Preventing and Mitigating SARS-CoV-2 Transmission — Four Overnight Camps, Maine, June–August 2020, Morbidity and Mortality Weekly Report (Sept. 4, 2020) (online at http://www.cdc.gov/mmwr/volumes/69/wr/mm6935e1.htm); Email from Michael Iademarco, Director of the Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, to Charlotte Kent, Chief of the Scientific Publications Branch, Centers for Disease Control and Prevention (Aug. 27, 2020) (SSCCManual_000017 – 22) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

20 Dr. Danae Bixler, et al., SARS-CoV-2–Associated Deaths Among Persons Aged <21 Years — United States, February 12–July 31, 2020, Morbidity and Mortality Weekly Report (Sept. 18 2020) (online at http://www.cdc.gov/mmwr/volumes/69/wr/mm6937e4.htm); Email from Nina Witkofsky, Acting Chief of Staff, Centers for Disease Control and Prevention, to Charlotte Kent, Chief of the Scientific Publications Branch, Centers for Disease Control and Prevention (Sept. 11, 2020) (SSCCManual_000007 – 10) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

21 Email from Madeleine Hubbard, Special Assistant, Department of Health and Human Services, to Paul Alexander, Senior Advisor, Department of Health and Human Services (June 30, 2020) (SSCC-0007093 – 110) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf). Dr. Kent, the Editor-in-Chief of the MMWR, told the Select Subcommittee that the full text of articles are not shared outside of CDC. See Transcribed Interview of Charlotte Kent (Dec. 7, 2020) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf) at 308, 1053 –1059.

22 Dr. Lara Bull-Otterson, et al., Hydroxychloroquine and Chloroquine Prescribing Patterns by Provider Specialty Following Initial Reports of Potential Benefit for COVID-19 Treatment — United States, January–June 2020, Morbidity and Mortality Weekly Report (Sept. 4, 2020) (online at http://www.cdc.gov/mmwr/volumes/69/wr/mm6935a4.htm).

23 Trump Tells the Story of a ‘Miracle’ Cure for COVID-19. But Was it?, National Public Radio (Apr. 7, 2020) (online at http://www.npr.org/sections/coronavirus ... but-was-it); Letter from Rear Admiral Denise M. Hinton, Chief Scientist, Food and Drug Administration, to Gary L. Disbrow, Deputy Assistant Secretary, Department of Health and Human Services (June 15, 2020) (online at http://www.fda.gov/media/138945/download).

24 The email attached a journal article regarding hydroxychloroquine prescription trends from October 2019 through March 2020, which Dr. Alexander appeared to mistake for the MMWR itself. See Email from Paul Alexander, Senior Advisor, Department of Health and Human Services, to Nina Witkofsky, Senior Advisor, Centers for Disease Control and Prevention, and Michael Caputo, Assistant Secretary for Public Affairs, Department of Health and Human Services (June 29, 2020) (SSCC-0007294 – 305) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

25 Email from Paul Alexander, Senior Advisor, Department of Health and Human Services, to Madeleine Hubbard, Special Assistant, Department of Health and Human Services (June 30, 2020) (SSCC-0006952 – 53) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

26 Email from Madeleine Hubbard, Special Assistant, Department of Health and Human Services, to Michael Caputo, Assistant Secretary for Public Affairs, Department of Health and Human Services, Paul Alexander, Senior Advisor, Department of Health and Human Services, and Brad Traverse, Senior Advisor, Department of Health and Human Services (July 2, 2020) (SSCC-0007178 – 81) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

27 Id.

28 Transcribed Interview of Charlotte Kent (Dec. 7, 2020) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf) at 1471 – 1483.

29 Id. at 765 – 802.

30 Email from Charlotte Kent, Chief of the Scientific Publications Branch, Centers for Disease Control and Prevention, to Paul Alexander, Senior Advisor, Department of Health and Human Services, et al. (July 28, 2020) (SSCC-0002881 – 88) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf) (emphasis added).

31 Email from Michael Beach, Associate Director, Centers for Disease Control and Prevention, to Charlotte Kent, Chief of the Scientific Publications Branch, Centers for Disease Control and Prevention, and Henry Walke, Incident Manager for COVID-19 Response, Centers for Disease Control and Prevention (July 27, 2020) (SSCCManual-000064 – 70) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

32 Email from Charlotte Kent, Chief of the Scientific Publications Branch, Centers for Disease Control and Prevention, to Anne Schuchat, Principal Deputy Director, Centers for Disease Control and Prevention (July 27, 2020) (SSCCManual_00071) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf); Email from Charlotte Kent, Chief of the Scientific Publications Branch, Centers for Disease Control and Prevention, to Paul Alexander, Senior Advisor, Department of Health and Human Services, et al. (July 28, 2020) (SSCC-0002881 – 88) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

33 Email from Charlotte Kent, Chief of the Scientific Publications Branch, Centers for Disease Control and Prevention, to Paul Alexander, Senior Advisor, Department of Health and Human Services, et al. (July 28, 2020) (SSCC-0002881 – 88) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf) (emphasis added).

34 Email from Charlotte Kent, Chief of the Scientific Publications Branch, Centers for Disease Control and Prevention, to MMWR staff (July 27, 2020) (SSCCManual-000086 – 93) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

35 Email from Charlotte Kent, Chief of the Scientific Publications Branch, Centers for Disease Control and Prevention, to Michael Iademarco, Director of the Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention (July 28, 2020) (SSCCManual-000059 – 61) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

36 Transcribed Interview of Charlotte Kent (Dec. 7, 2020) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf) at 1256 – 1259, 1283 – 1305.

37 Select Subcommittee on the Coronavirus Crisis, Hearing on “The Urgent Need for a National Plan to Contain the Coronavirus” (July 31, 2020) (online at https://coronavirus.house.gov/subcommit ... oronavirus).

38 Email from Paul Alexander, Senior Advisor, Department of Health and Human Services, to Michael Caputo, Assistant Secretary for Public Affairs, Department of Health and Human Services, et al. (July 27, 2020) (SSCC-0002911 – 13) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

39 Email from Paul Alexander, Senior Advisor, Department of Health and Human Services, to Madeleine Hubbard, Special Assistant, Department of Health and Human Services (July 31, 2020) (SSCC-0003286 – 93) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf); Email from Paul Alexander, Senior Advisor, Department of Health and Human Services, to Michael Caputo, Assistant Secretary of Public Affairs, Department of Health and Human Services, et al. (Aug. 2, 2020) (SSCC-0005298 – 301) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf); Email from Paul Alexander, Senior Advisor, Department of Health and Human Services, to Madeleine Hubbard, Special Assistant, Department of Health and Human Services, et al. (Aug. 5, 2020) (SSCC-0008029 – 33) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

40 Email from Paul Alexander, Senior Advisor, Department of Health and Human Services, to Michael Caputo, Assistant Secretary for Public Affairs, Department of Health and Human Services, and Robert Redfield, Director, Centers for Disease Control and Prevention, et al. (Aug. 8, 2020) (online at http://www.politico.com/f/?id=00000176- ... de870a0000).

41 Letter from Chairman James E. Clyburn, Select Subcommittee on the Coronavirus Crisis, to Secretary of Health and Human Services Alex M. Azar II and Director Robert R. Redfield, Centers for Disease Control and Prevention (Dec. 10, 2020) (online at https://coronavirus.house.gov/sites/dem ... 281%29.pdf).

42 See, e.g., Email from Charlotte Kent, Chief of the Scientific Publications Branch, Centers for Disease Control and Prevention, to Noah Aleshire, Associate Director for Policy and Strategy, Centers for Disease Control and Prevention (Sept. 17, 2020) (SSCCManual-000001 – 02) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

43 Email from Communications Specialist, Centers for Disease Control and Prevention, to Kate Galatas, Deputy Communications Director, Centers for Disease Control and Prevention, and Communications Specialist, Centers for Disease Control and Prevention (June 27, 2020) (SSCCManual-000186 – 89) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

44 Id.

45 White House Strips CDC of Data Collection Role for COVID-19 Hospitalizations, National Public Radio (July 15, 2020) (online at http://www.npr.org/sections/health-shot ... alizations).

46 Email from Kate Galatas, Deputy Communications Director, Centers for Disease Control and Prevention, to Robert R. Redfield, Director, Centers for Disease Control and Prevention, et al. (July 17, 2020) (SSCCManual-000190 – 95) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

47 Email from Kate Galatas, Deputy Communications Director, Centers for Disease Control and Prevention, to Anne Schuchat, Principal Deputy Director, Centers for Disease Control and Prevention, et al. (July 17, 2020) (SSCCManual-000174 – 79) (online at https://coronavirus.house.gov/sites/dem ... cted_0.pdf).

48 Email from Madeleine Hubbard, Special Assistant, Department of Health and Human Services, to Paul Alexander, Senior Advisor, Department of Health and Human Services (June 30, 2020) (SSCC-0007093 – 110) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf); see also Transcribed Interview of Charlotte Kent (Dec. 7, 2020) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf) at 726 – 729, 804 – 810.

49 See, e.g., Email from Paul Alexander, Senior Advisor, Department of Health and Human Services, to Charlotte Kent, Chief of the Scientific Publications Branch, Centers for Disease Control and Prevention, et al. (July 14, 2020) (SSCC-0006018 – 24) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf); Email from Charlotte Kent, Chief of the Scientific Publications Branch, Centers for Disease Control and Prevention, to Paul Alexander, Senior Advisor, Department of Health and Human Services, et al. (July 28, 2020) (SSCC-0002881 – 88) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf); Email from Kate Galatas, Deputy Communications Director, Centers for Disease Control and Prevention, to Robert R. Redfield, Director, Centers for Disease Control and Prevention, et al. (July 17, 2020) (SSCCManual-000190 – 95) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

50 Email from Paul Alexander, Senior Advisor, Department of Health and Human Services, to Katherine McKeogh, Press Secretary, Department of Health and Human Services, et al. (Sept. 9, 2020) (SSCC-0008026 – 28) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

51 Email from Michael Iademarco, Director of the Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, to Charlotte Kent, Chief of the Scientific Publications Branch, Centers for Disease Control and Prevention (Sept. 11, 2020) (SSCCManual-000016) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

52 Trump Officials Interfered with CDC Reports on Covid-19, Politico (Sept. 12, 2020) (online at http://www.politico.com/news/2020/09/11 ... -19-412809).

53 HHS Spokesman Caputo to Take Medical Leave After Reportedly Accusing CDC Officials of Plotting Against Trump, CNBC (Sept. 16, 2020) (online at http://www.cnbc.com/2020/09/16/hhs-spok ... trump.html).

54 Letter from Chairman James E. Clyburn, Select Subcommittee on the Coronavirus Crisis, to Secretary of Health and Human Services Alex M. Azar II (Sept. 14, 2020) (online at coronavirus.house.gov/sites/democrats.coronavirus.house.gov/files/2020-09-14.Majority%20to%20Azar%20and%20Redfield%20re%20HHS%20and%20CDC%20on%20Political%20Interference%20.pdf).

55 Letter from Sarah C. Arbes, Assistant Secretary for Legislation, Department of Health and Human Services, to Chairman James E. Clyburn, Select Subcommittee on the Coronavirus Crisis (Sept. 18, 2020) (online at coronavirus.house.gov/sites/democrats.coronavirus.house.gov/files/Clyburn%20TI%20Request%20Response%20%28signed%29.pdf).

56 Letter from Chairman James E. Clyburn, Select Subcommittee on the Coronavirus Crisis, to Secretary of Health and Human Services Alex M. Azar II (Sept. 22, 2020) (online at coronavirus.house.gov/sites/democrats.coronavirus.house.gov/files/2020-09-22.Clyburn%20to%20Azar%20re%20HHS%20TIs%20.pdf).

57 Letter from Sarah C. Arbes, Assistant Secretary for Legislation, Department of Health and Human Services, to Chairman James E. Clyburn, Select Subcommittee on the Coronavirus Crisis (Sept. 25, 2020) (online at coronavirus.house.gov/sites/democrats.coronavirus.house.gov/files/09252020%20Clyburn%20TI%20Request%20Follow%20Up%20Response.pdf).

58 Email from Staff, Select Subcommittee on the Coronavirus Crisis, to Staff, Department of Health and Human Services (Sept. 27, 2020).

59 Email from Staff, Department of Health and Human Services, to Staff, Select Subcommittee on the Coronavirus Crisis (Sept. 28, 2020).

60 Select Subcommittee on the Coronavirus Crisis, Hybrid Hearing with Secretary of Health and Human Services Alex M. Azar II (Oct. 2, 2020) (online at coronavirus.house.gov/subcommittee-activity/hearings/hybrid-hearing-secretary-health-and-human-services-alex-m-azar-ii).

61 Email from Staff, Department of Health and Human Services, to Staff, Select Subcommittee on the Coronavirus Crisis (Oct. 7, 2020).

62 Letter from Chairman James E. Clyburn, Select Subcommittee on the Coronavirus Crisis, to Secretary of Health and Human Services Alex M. Azar II (Oct. 22, 2020) (online at coronavirus.house.gov/sites/democrats.coronavirus.house.gov/files/2020-10-22.Clyburn%20to%20Azar%20re%20TIs%20.pdf).

63 HHS’s letter stated that the Department could begin producing documents on November 9, but only agreed to provide an “initial” production without revealing what this production would include or when the full set of responsive documents would be provided. Letter from Sarah C. Arbes, Assistant Secretary for Legislation, Department of Health and Human Services, to Chairman James E. Clyburn, Select Subcommittee on the Coronavirus Crisis (Oct. 27, 2020) (online at https://coronavirus.house.gov/sites/dem ... 0FINAL.pdf).

64 Email from Staff, Department of Health and Human Services, to Staff, Select Subcommittee on the Coronavirus Crisis (Oct. 29, 2020). The five “named custodians” are Alex M. Azar II, Robert R. Redfield, Michael Caputo, Paul Alexander, and Brad Traverse.

65 See, e.g¸ Email from Brett Giroir, Assistant Secretary for Health, Department of Health and Human Services, to Robert R. Redfield, Director, Centers for Disease Control and Prevention, et al. (Aug. 22, 2019) (SSCC-00013457) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf); Email from Robert Levitt to Robert Levitt (Nov. 28, 2019) (SSCC-0013402 – 11) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

66 See SSCC-0002546 – 96 (online at https://coronavirus.house.gov/sites/dem ... 546-96.pdf). In another instance, HHS appears to have withheld a copy of “a paper just published,” also on the basis of privilege. See Email from Paul Alexander, Senior Advisor, Department of Health and Human Services, to Michael Pratt, Director of Strategic Communications and Campaigns, Department of Health and Human Services, et al. (Aug. 30, 2020) (SSCC-0014927 – 29) (online at https://coronavirus.house.gov/sites/dem ... dacted.pdf).

67 Letter from Chairman James E. Clyburn, Select Subcommittee on the Coronavirus Crisis, to Secretary of Health and Human Services Alex M. Azar II and Director Robert R. Redfield, Centers for Disease Control and Prevention (Dec. 10, 2020) (online at https://coronavirus.house.gov/sites/dem ... 281%29.pdf).

68 Moreover, counsel’s questions—which sought information regarding whether anyone instructed Dr. Kent to withhold information from Congress—did not implicate attorney-client communications.

69 Letter from Chairman James E. Clyburn, Select Subcommittee on the Coronavirus Crisis, to Secretary of Health and Human Services Alex M. Azar II and Director Robert R. Redfield, Director, Centers for Disease Control and Prevention (Dec. 10, 2020) (online at https://coronavirus.house.gov/sites/dem ... 281%29.pdf).

70 Letter from Sarah C. Arbes, Assistant Secretary for Legislation, Department of Health and Human Services, to Chairman James E. Clyburn, Select Subcommittee on the Coronavirus Crisis (Dec. 15, 2020) (online at https://coronavirus.house.gov/sites/dem ... 201215.pdf).

71 Trump v. Mazars USA, LLP, 591 U.S. ___ (2020), quoting Watkins v. United States, 354 U.S. 178 (1957).

72 Barenblatt v. United States, 360 U.S. 109 (1959).
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