Nicole Fritz Columnist
US coronavirus response co-ordinator Deborah Birx gives a briefing at the White House in Washington, DC, the US. Picture: ANDREW HARRER/BLOOMBERG
US coronavirus response co-ordinator Deborah Birx gives a briefing at the White House in Washington, DC, the US. Picture: ANDREW HARRER/BLOOMBERG

Deborah Birx, co-ordinator of the White House coronavirus task force, was asked at a media briefing on Friday to respond, in light of Donald Trump’s enthusiastic promotion of hydroxychloroquine, to the recent Lancet study of the drug suggesting that it could cause heart problems and even increase the risk of mortality for coronavirus patients.

As a medical professional having sworn to uphold the Hippocratic Oath and at the fore of the US government’s response to an unprecedented health threat, you might imagine that she would use the opportunity to clearly and painstakingly endorse the findings of the study and use her time at the podium to leave Americans with no uncertainty that the taking of hydroxychloroquine to treat and prevent coronavirus is not only ill-advised but dangerous.

She didn’t. Instead she said what she had taken from the study, and what she hoped everyone else had taken, was the comorbidities that put individuals at greater risk of severe Covid-19 disease. Included in her non-response to the question was the observation that she hoped millennials might look at the study to see whether their grandparents or parents had such comorbidities and would help protect them.

In Birx’s case it seems plausible that she might refuse the opportunity to refute garbage so  she might stay to formulate policies and practices that are not garbage

It isn’t the first time Birx has been enmeshed in Trump’s wacky corona-related prescriptions. A few weeks ago she was forced to sit side-on, seemingly unable to hide her dismay, as Trump speculated that relief might be obtained from coronavirus infection by people injecting themselves with disinfectant. That time she was a mere spectator, and was not offered the platform to refute dangerous and deranged hypothesis that she then refused, as was the case last week.

The reason for scrutiny of Birx’s conduct is that, like Anthony Fauci, we do not imagine her a mere cipher for a Trump-led White House administration: an administration that has proved itself, at best, to be woefully underprepared and inept in the face of this crisis; more plausibly, criminally incompetent and callous. We assume of Fauci and Birx that as scientifically minded professionals who have long, distinguished careers behind them that they have put their personal preferences aside and are resolved to doing as much as they can to address the crisis in the way public health demands within an administration implacably opposed to science and expertise.

We assume that entails making excruciating compromises and agonising concessions — having to manage and, as required, genuflect to a petulant, tantrum-prone bully. It means putting their personal integrity and their professional records on the line.

Many have called for Fauci and Birx to be more categorical in their denunciation of Trump’s prescriptions. However, to do so would be to invite their dismissal by the orange-embalmed one, who’s probably already itching to do just that, and to be replaced by people more likely to nod enthusiastically at suggestions of disinfectant injection.

It’s possible to imagine of Birx and Fauci that they swim in sewage to take the American public to a place more clean — that they do some harm, are willing to perpetrate some harm, to do greater good. In Birx’s case it seems plausible that she might refuse the opportunity to refute garbage so she might stay to formulate policies and practices that are not garbage.

If that’s the calculation though, it must be hard to know if it is paying off. It involves measuring ultimately incommensurable things: one unquantifiable (the harm you helped create) against another unquantifiable (the harm you helped avoid); balancing a harm in which you are directly implicated against harms avoided to which you have indirectly contributed.

Without agreeing with the choices they’ve made, and perhaps extending undeserved generosity, it’s hard not to feel some sympathy for their position, or at least to engage in a more nuanced assessment than simple outright condemnation.

It’s worth asking who here is our equivalent of Birx and Fauci: people willing to stomach a lot of rubbish, to know even that they are complicit therein, so they might help to shape a considered, humane response to the pandemic.

• Fritz, a public interest lawyer, is CEO of Freedom Under Law.