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| Coronavirus Casts Unwelcome Spotlight on Trump’s Health Secretary | Coronavirus Casts Unwelcome Spotlight on Trump’s Health Secretary |
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| WASHINGTON — Two of President Trump’s top health officials were stewing last month in a drab room at the Centers for Disease Control and Prevention in Atlanta as Mr. Trump and his health secretary, Alex M. Azar II, were concluding a laboratory tour, one that they had been left off of. | WASHINGTON — Two of President Trump’s top health officials were stewing last month in a drab room at the Centers for Disease Control and Prevention in Atlanta as Mr. Trump and his health secretary, Alex M. Azar II, were concluding a laboratory tour, one that they had been left off of. |
| One of the officials, Dr. Jerome M. Adams, the surgeon general, was then invited to join the president and the secretary to shake hands. The other, Seema Verma, who leads the Centers for Medicare and Medicaid Services, was not. Instead, a staff member told the powerful Medicare chief to head to the receiving line with the rank and file. Furious, she left for the airport to catch a commercial flight home to Washington. | One of the officials, Dr. Jerome M. Adams, the surgeon general, was then invited to join the president and the secretary to shake hands. The other, Seema Verma, who leads the Centers for Medicare and Medicaid Services, was not. Instead, a staff member told the powerful Medicare chief to head to the receiving line with the rank and file. Furious, she left for the airport to catch a commercial flight home to Washington. |
| The episode from March 6, described by senior administration officials who believed Mr. Azar was behind the snub, illustrated to them why Mr. Azar’s future as secretary of health and human services is a constant question, even as his sprawling department battles the worst public health crisis in a century. Where Mr. Azar goes, personal conflicts seem to follow, senior administration officials say. Officials at the Department of Health and Human Services disputed that notion. | The episode from March 6, described by senior administration officials who believed Mr. Azar was behind the snub, illustrated to them why Mr. Azar’s future as secretary of health and human services is a constant question, even as his sprawling department battles the worst public health crisis in a century. Where Mr. Azar goes, personal conflicts seem to follow, senior administration officials say. Officials at the Department of Health and Human Services disputed that notion. |
| The department’s newly installed spokesman, Michael R. Caputo, dismissed such talk as beside the point. | The department’s newly installed spokesman, Michael R. Caputo, dismissed such talk as beside the point. |
| “I can tell you that the American people want information they can use to fight the coronavirus, not palace intrigue,” he said. | “I can tell you that the American people want information they can use to fight the coronavirus, not palace intrigue,” he said. |
| But even before the coronavirus pandemic, senior White House officials had grown deeply frustrated with Mr. Azar and his management of the department. | But even before the coronavirus pandemic, senior White House officials had grown deeply frustrated with Mr. Azar and his management of the department. |
| His toxic relationship with Ms. Verma became so ugly and public last year that the two were summoned to the White House in December to determine whether they could continue to work together. Mr. Azar has also repeatedly clashed with Joe Grogan, the director of the White House’s Domestic Policy Council, who two senior administration officials said would soon leave his post. In recent weeks, several people close to the president grew even angrier with Mr. Azar for what they viewed as a public relations effort on his part to generate favorable coverage of his response to the virus at the president’s expense. | His toxic relationship with Ms. Verma became so ugly and public last year that the two were summoned to the White House in December to determine whether they could continue to work together. Mr. Azar has also repeatedly clashed with Joe Grogan, the director of the White House’s Domestic Policy Council, who two senior administration officials said would soon leave his post. In recent weeks, several people close to the president grew even angrier with Mr. Azar for what they viewed as a public relations effort on his part to generate favorable coverage of his response to the virus at the president’s expense. |
| Now, Mr. Azar finds himself increasingly sidelined by Mr. Trump and his advisers, who blame the secretary for early failures on testing and for what they describe as inconsistent stewardship of the coronavirus task force in its first month. | Now, Mr. Azar finds himself increasingly sidelined by Mr. Trump and his advisers, who blame the secretary for early failures on testing and for what they describe as inconsistent stewardship of the coronavirus task force in its first month. |
| Over the weekend, the president denied that he was preparing to fire Mr. Azar, calling the reports “Fake News” and saying Mr. Azar was doing “an excellent job!” | Over the weekend, the president denied that he was preparing to fire Mr. Azar, calling the reports “Fake News” and saying Mr. Azar was doing “an excellent job!” |
| But Vice President Mike Pence took over for Mr. Azar as the leader of the task force at the end of February, and in the weeks since the episode at C.D.C. headquarters, Mr. Azar has been excluded from key coronavirus meetings, administration officials say, including one led by Mr. Grogan and another involving only the nation’s top medical officials. | But Vice President Mike Pence took over for Mr. Azar as the leader of the task force at the end of February, and in the weeks since the episode at C.D.C. headquarters, Mr. Azar has been excluded from key coronavirus meetings, administration officials say, including one led by Mr. Grogan and another involving only the nation’s top medical officials. |
| “These are all arguably people who theoretically report to him, work for him, but like everything else, that has been upended in this administration, where it isn’t very clear if cabinet secretaries are choosing or even co-choosing their top political appointees,” said Kathleen Sebelius, a health and human services secretary under President Barack Obama. “I don’t have any idea how you operate in that environment when you’re excluded from meetings with your agency.” | “These are all arguably people who theoretically report to him, work for him, but like everything else, that has been upended in this administration, where it isn’t very clear if cabinet secretaries are choosing or even co-choosing their top political appointees,” said Kathleen Sebelius, a health and human services secretary under President Barack Obama. “I don’t have any idea how you operate in that environment when you’re excluded from meetings with your agency.” |
| Aides to Mr. Azar say he remains fully in charge of his department and is an integral part of the administration’s response to the virus. White House officials continue to dismiss questions about his status. | Aides to Mr. Azar say he remains fully in charge of his department and is an integral part of the administration’s response to the virus. White House officials continue to dismiss questions about his status. |
| “Even with the president’s tweet on Sunday flatly denying rumors that Secretary Azar is on his way out or that he is doing anything other than an excellent job, the media is still focused on outrageous claims of palace intrigue that are only meant to distract the American people from the Trump administration’s bold leadership in response to this pandemic,” said Judd Deere, a White House spokesman. | “Even with the president’s tweet on Sunday flatly denying rumors that Secretary Azar is on his way out or that he is doing anything other than an excellent job, the media is still focused on outrageous claims of palace intrigue that are only meant to distract the American people from the Trump administration’s bold leadership in response to this pandemic,” said Judd Deere, a White House spokesman. |
| But the monthslong coronavirus crisis has exacerbated deep and longstanding divisions between Mr. Azar, a former pharmaceutical executive, and political officials in other parts of the administration, including some of those closest to Mr. Trump in the White House. | But the monthslong coronavirus crisis has exacerbated deep and longstanding divisions between Mr. Azar, a former pharmaceutical executive, and political officials in other parts of the administration, including some of those closest to Mr. Trump in the White House. |
| In the last several weeks, the president grew angry with Mr. Azar after articles in The Washington Post and The New York Times depicted the White House as slow to respond to the coronavirus outbreak, according to several officials familiar with his thinking. They said Mr. Trump was enraged that he was being criticized in accounts that portrayed Mr. Azar as having been aggressive in responding to the threat early on. | In the last several weeks, the president grew angry with Mr. Azar after articles in The Washington Post and The New York Times depicted the White House as slow to respond to the coronavirus outbreak, according to several officials familiar with his thinking. They said Mr. Trump was enraged that he was being criticized in accounts that portrayed Mr. Azar as having been aggressive in responding to the threat early on. |
| Mr. Azar’s allies say he was one of the few people who tried to alert the West Wing to a looming public health crisis in January and early February. They note that some officials accused Mr. Azar of being “an alarmist” for his repeated warnings about the coronavirus at a time when Mr. Trump was publicly playing down the threat. | Mr. Azar’s allies say he was one of the few people who tried to alert the West Wing to a looming public health crisis in January and early February. They note that some officials accused Mr. Azar of being “an alarmist” for his repeated warnings about the coronavirus at a time when Mr. Trump was publicly playing down the threat. |
| But others have said Mr. Azar was not clear enough with Mr. Trump about the magnitude of the threat. Several aides to the president said that Mr. Azar was so focused on keeping his job and preserving his standing in the White House that he gave conflicting information — dire one day, optimistic the next — that ended up confusing Mr. Trump and his senior advisers. | But others have said Mr. Azar was not clear enough with Mr. Trump about the magnitude of the threat. Several aides to the president said that Mr. Azar was so focused on keeping his job and preserving his standing in the White House that he gave conflicting information — dire one day, optimistic the next — that ended up confusing Mr. Trump and his senior advisers. |
| Some of Mr. Azar’s critics have even accused him of misleading top White House officials. Last week, senior officials felt blindsided when Dr. Rick Bright, the head of a crucial drug and vaccine development unit at Department of Health and Human Services, issued a blistering statement saying he had been removed from his post after he resisted political pressure to back unproven drugs publicly heralded by the president. In a meeting in the Situation Room moments earlier, Mr. Azar had told the vice president that Mr. Bright had received a promotion. | Some of Mr. Azar’s critics have even accused him of misleading top White House officials. Last week, senior officials felt blindsided when Dr. Rick Bright, the head of a crucial drug and vaccine development unit at Department of Health and Human Services, issued a blistering statement saying he had been removed from his post after he resisted political pressure to back unproven drugs publicly heralded by the president. In a meeting in the Situation Room moments earlier, Mr. Azar had told the vice president that Mr. Bright had received a promotion. |
| The episode at the C.D.C. headquarters has also reverberated with White House and health officials, some of whom saw it as an example of Mr. Azar’s pettiness. Ms. Verma had made a special effort to get to Atlanta after traveling the day before with Mr. Pence, catching up to the president after his tour had been canceled, then abruptly put back on his schedule. | The episode at the C.D.C. headquarters has also reverberated with White House and health officials, some of whom saw it as an example of Mr. Azar’s pettiness. Ms. Verma had made a special effort to get to Atlanta after traveling the day before with Mr. Pence, catching up to the president after his tour had been canceled, then abruptly put back on his schedule. |
| But she was left off the president’s tour, which unfolded on national television. Mr. Azar stood with Mr. Trump, who wore a red “Keep America Great” hat produced by his re-election campaign, and Dr. Robert R. Redfield, the director of the C.D.C., for almost an hour as the president extolled his administration’s work. Ms. Verma and Dr. Adams were nowhere to be seen. To then be told to join a receiving line with other guests waiting to shake Mr. Azar’s hand infuriated Ms. Verma. | But she was left off the president’s tour, which unfolded on national television. Mr. Azar stood with Mr. Trump, who wore a red “Keep America Great” hat produced by his re-election campaign, and Dr. Robert R. Redfield, the director of the C.D.C., for almost an hour as the president extolled his administration’s work. Ms. Verma and Dr. Adams were nowhere to be seen. To then be told to join a receiving line with other guests waiting to shake Mr. Azar’s hand infuriated Ms. Verma. |
| One senior administration official, who spoke on the condition of anonymity to discuss the events, insisted that Mr. Azar had no knowledge of the staging of the C.D.C. event, and that it was dictated by White House advance officials. | One senior administration official, who spoke on the condition of anonymity to discuss the events, insisted that Mr. Azar had no knowledge of the staging of the C.D.C. event, and that it was dictated by White House advance officials. |
| Mr. Azar remains a member of the primary coronavirus task force and continues to be an active participant in the group’s meetings, though for weeks he has not appeared regularly alongside the president or vice president during the daily news conferences held afterward. In recent weeks, Mr. Azar has also made fewer appearances in the national news media, which are coordinated through Mr. Pence’s office. | Mr. Azar remains a member of the primary coronavirus task force and continues to be an active participant in the group’s meetings, though for weeks he has not appeared regularly alongside the president or vice president during the daily news conferences held afterward. In recent weeks, Mr. Azar has also made fewer appearances in the national news media, which are coordinated through Mr. Pence’s office. |
| He has also been missing from the “operational check-ins” held before the task force’s meetings where officials organize and prepare. The gatherings in the Roosevelt Room are led by Mr. Grogan and include the heads of the key health agencies within the Department of Health and Human Services, including the C.D.C., the National Institute of Allergy and Infectious Diseases and the Food and Drug Administration. | He has also been missing from the “operational check-ins” held before the task force’s meetings where officials organize and prepare. The gatherings in the Roosevelt Room are led by Mr. Grogan and include the heads of the key health agencies within the Department of Health and Human Services, including the C.D.C., the National Institute of Allergy and Infectious Diseases and the Food and Drug Administration. |
| Mr. Grogan has told associates that he purposefully excluded Mr. Azar, according to one senior administration official. | Mr. Grogan has told associates that he purposefully excluded Mr. Azar, according to one senior administration official. |
| Updated June 22, 2020 | |
| A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico. | |
| The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. | The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. |
| The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. | The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. |
| So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. |
| A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. |
| The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. |
| States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. | States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. |
| If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. | If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. |
| Mr. Azar is not a part of the regular meetings of a group of the administration’s senior health officials with medical degrees, including Dr. Anthony S. Fauci, the federal government’s top infectious disease expert, and Dr. Deborah L. Birx, the White House’s coronavirus response coordinator. | Mr. Azar is not a part of the regular meetings of a group of the administration’s senior health officials with medical degrees, including Dr. Anthony S. Fauci, the federal government’s top infectious disease expert, and Dr. Deborah L. Birx, the White House’s coronavirus response coordinator. |
| “If you don’t have the health secretary as the lead, it’s very unclear who is the lead,” Ms. Sebelius said. | “If you don’t have the health secretary as the lead, it’s very unclear who is the lead,” Ms. Sebelius said. |
| The recent tensions have prompted White House officials, including Mark Meadows, the new chief of staff, to discuss possible replacements for Mr. Azar once the coronavirus crisis stabilizes, according to senior administration officials. Among the names discussed have been Ms. Verma, Dr. Birx and Dr. John C. Fleming, a former House Republican and official at the Department of Health and Human Services who is now an aide to Mr. Meadows. | The recent tensions have prompted White House officials, including Mark Meadows, the new chief of staff, to discuss possible replacements for Mr. Azar once the coronavirus crisis stabilizes, according to senior administration officials. Among the names discussed have been Ms. Verma, Dr. Birx and Dr. John C. Fleming, a former House Republican and official at the Department of Health and Human Services who is now an aide to Mr. Meadows. |
| But some of Mr. Trump’s aides cautioned that advisers had gotten ahead of themselves by putting out word that Mr. Azar could be replaced in the coming weeks. Senior administration officials say the president will most likely wait until the summer to make a change, once the immediate crisis has diminished, if he makes one at all before the election. | But some of Mr. Trump’s aides cautioned that advisers had gotten ahead of themselves by putting out word that Mr. Azar could be replaced in the coming weeks. Senior administration officials say the president will most likely wait until the summer to make a change, once the immediate crisis has diminished, if he makes one at all before the election. |
| Mr. Azar has told several administration officials that he wants to leave his post on his own terms. | Mr. Azar has told several administration officials that he wants to leave his post on his own terms. |
| But if Mr. Azar is removed, it will not just be the result of concerns about the administration’s response to the coronavirus. Mr. Grogan fought regularly with Mr. Azar over efforts to lower prescription drug prices, an issue Mr. Trump sees as central to his health agenda. | But if Mr. Azar is removed, it will not just be the result of concerns about the administration’s response to the coronavirus. Mr. Grogan fought regularly with Mr. Azar over efforts to lower prescription drug prices, an issue Mr. Trump sees as central to his health agenda. |
| Mr. Trump also blamed Mr. Azar for aggressively pushing for a partial ban on flavored e-cigarettes, a decision the president made in January and then quickly regretted, advisers said. He berated Mr. Azar about it in a call on Jan. 16 in front of his political advisers. | Mr. Trump also blamed Mr. Azar for aggressively pushing for a partial ban on flavored e-cigarettes, a decision the president made in January and then quickly regretted, advisers said. He berated Mr. Azar about it in a call on Jan. 16 in front of his political advisers. |
| Mr. Azar’s well-documented battles with Ms. Verma now extend to which of them is seen as controlling the distribution of congressionally approved money to health care providers. While Mr. Azar attended the funeral for his father this month, officials in Mr. Pence’s office signed off on Ms. Verma making the announcement, a White House official said. The official said that Mr. Pence was acting out of a desire to get the money out the door, not to slight Mr. Azar. | Mr. Azar’s well-documented battles with Ms. Verma now extend to which of them is seen as controlling the distribution of congressionally approved money to health care providers. While Mr. Azar attended the funeral for his father this month, officials in Mr. Pence’s office signed off on Ms. Verma making the announcement, a White House official said. The official said that Mr. Pence was acting out of a desire to get the money out the door, not to slight Mr. Azar. |
| In recent days, the White House installed Mr. Caputo, a longtime Trump loyalist with no background in health care, as the top communications official at the Department of Health and Human Services, an attempt to manage how Mr. Azar and his staff are interacting with reporters. | In recent days, the White House installed Mr. Caputo, a longtime Trump loyalist with no background in health care, as the top communications official at the Department of Health and Human Services, an attempt to manage how Mr. Azar and his staff are interacting with reporters. |
| Noah Weiland and Michael D. Shear reported from Washington, and Maggie Haberman from New York. | Noah Weiland and Michael D. Shear reported from Washington, and Maggie Haberman from New York. |