Adm. Brett Giroir, M.D. — Right Guy, Right Time, Right Place
A Review of Covid “Testing Czar” Brett Giroir’s Recent Book, “Memoir of a Pandemic”
A quick preamble regarding all things Covid: This is not a political diatribe slamming the multitude of Trump and Biden Administration players involved in fighting the pandemic. Move on if seeking gratuitous negativity.
The mission behind this longer-form piece is discussing the recently released book by former Trump Administration Covid “testing czar” Adm. Brett Giroir, M.D. in several different contexts:
First, how a previously anonymous public official successfully adapted to being thrust into the national limelight; Second, the strategic tactical and messaging considerations that optimized Giroir’s ability to convey important public health information in an oversaturated news marketplace; Third, how a data-focused, non-partisan approach to newsmaking was foundational to his challenging ‘learn as you go’ success as a communicator.
The following are my own viewpoints, opinions and observations about what transpired working with Dr. Giroir and team at the U.S. Dept of Health and Human Services (HHS) in 2020 — with several years of beneficial perspective.
Some spend their entire lives chasing fame and recognition. Then there are the rare few who end up in the national spotlight at the intersection of fate, circumstance, and preparation.
Such is the case with Adm. Brett Giroir, M.D.
Over three years have gone by since Covid’s ignominious 2020 arrival, the “Public Health Emergency” is officially over, and the 24/7 cable news cacophony is thankfully long gone.
But zero-sum finger pointing inside the Beltway remains a constant as new Covid cases make headlines and the congressional committee charged with detailing pandemic response errors — and how best to confront the next one — is mired in a partisan ditch.
A bevy of books about the pandemic’s broader policy, public health and political implications are in the public domain. It seems a majority of these accounts are ideological screeds, rote partisan talking points, and petty payback efforts.
Conversely, former Trump Administration Covid “testing czar” Brett Giroir’s book — Memoir of a Pandemic: Fighting COVID from the Front Lines to the White House — serves up noteworthy, unusually candid first-hand observations about policy, personalities, and power.
His synthesis of personal reflection, infectious disease historical context and linear recounting of his time as HHS Asst. Sec. for Health (OASH) and a White House coronavirus task force member is also something more.
It’s a good read.
Dr. Giroir details his intent at the outset:
“The purpose of this book is to venture beyond the political rhetoric, inaccuracies, reputation salvaging, and oversimplification…
“Here, I recount the major events in the Trump Administration’s pandemic response as I personally witnessed them, from the front lines on cruise ships and makeshift hospitals to the Situation Room in the White House.”
The 294-page account is also a refreshing reminder that most who “do time” in Washington are there to serve their country, do their best, then return home. In Giroir’s case, ‘home’ is College Station, TX.
Originally from Louisiana — and first in his family to attend college — he graduated magna cum laude with a biology degree from Harvard. He then pursued a career as a pediatric critical care specialist. As a physician-scientist, he has also served as an Admiral in the U.S. Public Health Service Commissioned Corps (USPHS); U.S. Rep. on the World Health Organization (WHO) executive board; Acting Commissioner of the Food and Drug Administration (FDA); and from 2004–2008 he led the Science Office at the Defense Advanced Research Projects Agency (DARPA).
HHS colleagues addressed him as either “Dr. Giroir” or “Admiral Giroir.” I preferred “Admiral” — because that was how millions of Americans came to know him on.
In January 2020 — the earliest days of the eventual worldwide pandemic — Giroir was among the first federal leaders tapped to handle the reintegration of U.S. citizens from Wuhan, China. As such, he was one of the few to see what everyone believed were the only handful of Americans exposed to the novel virus at the time.
The rest, so to speak, is history.
By mid-2020, he was a ubiquitous TV presence as the pandemic unfolded against a backdrop of fear, confusion, and precipitous collapse of a 20th century U.S. public health infrastructure ill-equipped to fight a 21st century virus.
It’s my opinion that no matter who was president at the outset of Covid, a public health catastrophe would have occurred. I liken it in layman’s terms to aliens landing on earth with deadly, unfathomable weapons beyond our technological comprehension. With time, technology, quintessential U.S. know-how — and successes and failures from both the Trump and Biden Administrations — we were able to fight back.
I also concur with Giroir’s objective, big picture viewpoint at the book’s outset eschewing the partisan blame game:
“President Trump was no more personally responsible for the 400,000+ deaths that occurred during his term than President Biden is personally responsible for the 600,000+ deaths (and thousands more in the future) that have occurred under his administration.”
Indeed, Republicans who make sweeping, weaponized statistical conclusions — such as Biden did a “worse” job than Trump because more died under the current president’s watch — are as off-base as Democrats who blame Trump for the inability to arrest the initial 2020 outbreak.
Throughout his text, moreover, Giroir details how both Administrations did some things right and others wrong:
“The Trump administration — including my team and I — did many things right, to an exemplary degree, but we also made mistakes that led to confusion among the American people and may have cost lives. And of course, the entire pandemic response — and certainly public health communication to the American people — was made infinitely more difficult and complex by the most divisive presidential election in the history of our country.”
Giroir earns credibility points from the outset.
1 — “Anybody Who Wants a Test Can Get a Test” … The Technology, Manufacturing and Scaling Challenge
Covid testing setbacks — and a lack of U.S. production capacity at the scale required — were front and center in early 2020. It didn’t help bring about clarity when President Trump wrongly asserted in March 2020 that “anybody who wants a test can get a test.”
Existing technology, requiring a nasal swab being sent to a lab, took several days to get results. By the time results were known, those infected may have infected others. This led to cries for “contact tracing” — tracking citizens’ whereabouts if they were Covid positive.
Contact tracing was “working” in South Korea, pleaded some public health advocates. But this was always a non-starter in the U.S. where being surveilled and tracked by government at any level is anathema.
“Rapid tests” were needed, with results in minutes. An effective rapid test manufacturing capacity became the priority.
It was reported in March 2020 that a “SWAT team” of “fixers and technocrats to ramp up testing” led by Giroir had been assembled and deployed. On a parallel track, meanwhile, HHS Sec. Alex Azar and staff staff were working towards getting Operation Warp Speed’s (OWS) vaccine initiative off the ground.
HHS was a focal point of activity and fascinating place to be in mid-2020. Most career staff worked from home and the cavernous building at the base of Capitol Hill — with long, maze-like hallways — maintained an air of Dystopian desolation.
But the silence in most of the building was deceptive. The top floors were abuzz with senior Pentagon officials who’d commandeered space to jumpstart OWS. Data scientists and infectious disease specialists of all kinds took up residence in other parts of the building.
The “testing czar” moniker was swiftly bestowed upon Giroir by an ever-growing Covid-beat media horde in Washington, New York and around the world. Out in the real world, long lines of cars with fearful occupants waiting to be swabbed and tested became a staple of cable news imagery and coverage — especially in sunbelt Covid hotspot states like Florida, Texas, Arizona and California.
Hazmat-like full body garb became commonplace in public spaces as the efficacy of masks and social distancing became an angry point of social and political contention. Eldercare facilities suffered growing chaos and deaths while schools of every kind shuttered.
With a White House devoid of standard daily press briefings, the primary source of “official” Covid information, other than leaks, were the Trump-led White House news conferences attended by Vice-President Mike Pence, Dr. Anthony Fauci, Dr. Deborah Birx, Dr. Giroir and a host of other coronavirus task force members.
Giroir was increasingly called upon to answer questions at the White House briefings as a lack of tests and capacity became a worsening political and public health controversy. This was a challenging time for the new testing czar as his early 2020 public comments about improved testing processes were, by circumstance, more aspirational than concrete.
Anthony Fauci, Director of the Natl. Institute of Allergy and Infectious Diseases (NIAID) was already on his way to becoming the most visible public face of the Trump Administration’s pandemic response. Fauci already had an established relationship with dozens of longtime national health journalists because of his work fighting AIDS in the early 90’s.
Fauci was an obvious ‘go-to’ guy for the media.
Giroir’s public profile, conversely, came out of nowhere.
2 — Realities and Challenges of Sudden High-Profile Media Engagement
In spring of 2020, Brett Giroir was a government official walking through airports in stark anonymity. By July, passersby would do a double take knowing they’d seen that guy — “The Admiral” — on TV.
Americans grew increasingly accustomed to seeing the dapper, white-haired “testing czar” on a host of ideologically diverse cable and broadcast news outlets.
From an on-camera perspective, Giroir was right out of central casting. It was to his immediate benefit. He was an Admiral — and looked like one.
Whether he wore his dress uniform or the more commonly worn operational dress uniform to emphasize the USPHS’s front-line public health defense readiness, most viewers and the media at-large likely mistook Giroir for a U.S. Navy Admiral.
No matter. He looked great on TV — and exuded an authoritative, confident manner.
His powerful visual imprimatur — combined with subject matter expertise, preparation skill, and ability to assimilate and explain real time state and local Covid infection data — served as the 4 cornerstones of his evolving media engagement success.
His primary initial disadvantage? Lack of live, on-camera experience and the sheer velocity and volume of the incoming media inquiries. But anyone thrust into this situation would face a steep learning curve. Giroir had to adapt and learn as we proceeded — mostly on the fly. And he did.
In addition to rightly singling out his OASH director of external affairs, Mia Heck, for successfully taking on an ever-growing load of media responsibilities, Giroir points out in his text that HHS Asst. Sec. for Public Affairs, Michael Caputo, counseled the White House that doctors — not politicians and bureaucrats — should be the face of the response.
This helped clear approval for Giroir media appearances that, based on merit, further vaulted Giroir into the national spotlight. Cable news programming staff and “bookers” spend their days looking for new, articulate talent to feature. The new testing czar rose steadily in the pecking order and the marketplace.
Despite strong foundational staff work from Heck, Caputo and a skilled HHS communications and policy team assembled by Sec. Azar, it was Giroir himself who had to cross a credibility threshold over time. The ravenous DC media horde is always looking for a fresh scalp to claim and new butt to kick — especially if you’re unproven in high-profile media battle.
You don’t just “show up” in Washington on all the major news shows and at White House press briefings — as did Giroir — without being put through the ritualistic wringer.
That’s just the way it is.
One TV news executive friend concurred the new testing czar looked good on TV — but still had to “prove he’s not just another Trump Administration whack job.” She cited the fact senior White House Advisor Peter Navarro was extolling the virtues of hydroxychloroquine as an effective Covid therapeutic.
The media kicked the tires hard on Giroir’s base of knowledge and ability to discuss testing processes, technology, and plan to slow the spread of infections. It was a rough ride.
Moreover, we had to accept the reality that journalists wanted Giroir to contradict Trump, other Administration officials, Capitol Hill Republicans, or other public health “experts” to facilitate writing negative ledes and headlines about confusion and chaos.
Giroir didn’t appreciate or like these “media games.” He found this ‘gotcha gamesmanship’ irritating, to put it charitably. But one person’s “media games” is another’s “media responsibility” to get straight answers on federal policymaking and accountability.
You can’t change the media — you can only modify and optimize your message and approach to communicating.
A quick study, Giroir saw via the actual results of his own words and manner of answering media questions how to get the ‘best’ result in an arena where ‘perfection’ is illusory.
Remaining upbeat, calm, sidestepping obvious bait, and steering discussion back to data — and what it means — resulted in the best outcome for the dozens of TV, print and wire stories filed daily.
Giroir’s swift evolution to accepting the fact journalists would consistently frame certain question in certain ways was another key to his ascent as an effective national level communicator. So, too, was his firm, sure-footed style when rebutting a questioner whose query premise was contextually flawed — or just wrong.
Giroir could disagree without being disagreeable.
In defense of the collective media’s Covid coverage, death and growing death counts are and always should be news. Morbid “body count” graphics and breathless “breaking news” alerts at the top of every hour were as confounding to the Biden pandemic response team as they were to Trump’s.
3 — Developing, Implementing a Standard Communications Process
By July 2020, Giroir’s office went from getting dozens of media queries daily to over 100 in some instances. The HHS broadcast studio became a second home for live TV interviews.
But for the avalanche of non-TV requests, we decided Giroir should conduct a 30-minute media teleconference call every several days to relieve pressure on “incoming” and to answer queries in more of a batch mode.
Our basic approach to media call format was a 5-minute overview and Giroir narrative at the top of the call to detail new infection data and findings — good and bad. He would then detail any new information about rapid test progress, federal collaboration with various companies, and when and where the new tests would become available.
Test development progress over the summer was swift. Giroir’s work with Abbott facilitated deployment of its BinaxNOW antigen test while other firms like BD, Quidel and Cue Health worked to field their rapid test products.
This was always desirable ‘new news’ we sought to discuss as frequently as possible. In effect, rapid test development and deployment was our only “offense” on the newsmaking front.
Giroir would then answer routine queries — almost always framed pejoratively — about what the data means and how it might impact states and local jurisdictions. Despite his solid working relationship with a number of GOP and Democratic Governors, local officials lobbed regular charges our way about a wide gamut of topics. Those, too, had to be answered as state level TV, print and wire reporters increasingly joined the calls.
Despite the fact our media Q and A segment could — and did — devolve into a free-for all if a new Covid-related Trump or Biden campaign controversy had chummed the media waters, we settled into this basic media call format.
But consciously not part of Giroir’s presentation was speculative spin and hyperbole. Spin and hyperbole are an accepted, traditional element of political and campaign communications.
Not so for life and death public health information.
“Bad news” regarding national, state, and local infection data was not malleable — it was what it was. And for weeks at a time through the summer, the data — and the resulting coverage — was consistently negative.
Despite Giroir’s growing savvy and confidence both on-camera and handling dozens of aggressive reporters via teleconference, he occasionally — but necessarily — got crosswise with the President, resulting in 48–72 hour firestorms of controversy.
Two cases in point:
First, he contradicted the Trump assertion Covid caseloads were rising simply because more tests were detecting more cases. That simply was not the case.
Second, Giroir’s public rejection of hydroxychloroquine as an effective Covid therapy during an August 2020 Meet the Press appearance with Chuck Todd caused a predictable firestorm — and a public rebuke from Trump advisor Peter Navarro.
Following Giroir’s discussion with Chuck Todd — arguably among his best high-profile national appearances among dozens — he describes the Navarro aftermath:
“On August 2, 2020, I had a good interview on the Sunday morning show Meet the Press on NBC. It was a typically tough interview, but near the end, the host asked me about the president and hydroxychloroquine.
“I tried to never overtly contradict the president, but I had a responsibility to provide the best information to the American public. I said, “Most physicians and prescribers are evidence based, and they’re not influenced by whatever is on Twitter or anything else. And the evidence just does not show hydroxychloroquine is effective right now. We need to move on from that and talk about what is effective.
“Of course, my “breaking with the president” was the only headline in the national press after that interview, and Peter Navarro attacked me publicly the next day. He said I had not read the data and that medical doctors’ opinions were a dime a dozen. Of course, I had read the data, and he knew that. So again, his fervor to defend the president combined with his shotgun dismissal of anyone who was even partially aligned with Fauci got in the way of the scientific truth. I was not as mad at him as I should have been because I knew (hoped?) that no one would take his medical opinions seriously.”
Giroir’s credibility was also enhanced throughout the year because we took all so-called “mainstream media” comers. An outlet’s ideological proclivity was never a criterion for determining access to Giroir.
While there are too many print and wire reporters to name with whom Giroir and his media team developed a sound working relationship, he expressed a positive view of several TV interlocutors across the ideological spectrum: Bret Baier, Dana Perino and Harris Faulkner at Fox News; Jake Tapper, Michael Smerconish and Chris Cuomo (then) at CNN; Andrea Mitchell at MSNBC, and Weija Chang at CBS News.
We also rejected frequent “advice” from a cottage industry of outside media strategists that Giroir would get “better coverage” by blowing off “mainstream media” broadcast and print outlets with whom we engaged daily. We should stick to “friendly” TV, print and other outlets.
That was horrendous counsel.
Interestingly, and to their credit, the White House communications team never once urged us to change course or limit media engagement.
Along these lines, Giroir makes an interesting observation about the disconnect between what Trump might say about Covid on the campaign trail and the subsequent federal policy guidance offered by White House coronavirus task force doctors:
“It was Trump’s “campaign persona” that got sideways with task force recommendations and caused all the doctors on the task force great stress and distress. Trump’s campaign persona began to dominate the scene in early summer when he was on the campaign trail; during that time, he did not attend task force meetings and only rarely was directly briefed by the core task force doctors…
“What happened on the campaign trail never influenced our recommendations to the American people. It also never seemed to affect Trump’s support for the task force’s ongoing recommendations to governors and the public…
“Trump’s actions and policies for the nation were often contradictory to his practices on the campaign trail.”
While this piece is devoted to how Brett Giroir navigated his unexpected turn in the public spotlight, this passage about what he did immediately prior to his final White House coronavirus taskforce meeting reveals a lot about his view of public service:
“After testing, instead of remaining on the ground floor, I went up one staircase to my favorite place to hang out prior to Situation Room or Oval Office meetings and I wanted to do that just one more time.
“EEOB Room 180 is used as a basic conference room now, but it is quite historic, even though it never appears on any EEOB tours. This was Nixon’s “hideaway office” where he preferred to work and where many of the Watergate tapes were originally recorded. Vice Pres. Hubert Humphrey also used this office because Pres. Lyndon Johnson kept the official office of the vice president (on the second floor of the EEOB) for himself after Kennedy’s assassination.
“That was cool enough, but more importantly, this room was the site of a historic meeting between Vice President Humphrey and Rev. Dr. Martin Luther King Jr. that led to a significant acceleration of the civil rights movement. There are several black-and-white photos hanging in EEOB 180 to document this meeting, and sitting and working beneath those photos always affected me deeply and elevated my sense of purpose and history.”
In a personal realm, Brett Giroir has a strong sense of public duty and love of country. He’s also the type of person every American would want and trust to be serving the nation on their behalf in a crisis.
In a professional sense, a final thought:
I’ve seen too many in Washington make the mistake of trying too hard to naively coddle or “befriend” journalists in the hope of impacting reporting.
In fact, high-level newsmakers can succeed by simply being straightforward, honest, reliable and making their point succinctly.
And if one can do so by being pleasant — but firm and resolute in the process — all the better.
Easier said than done. But this formula worked for Brett Giroir.
