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C.D.C. Coronavirus Testing Guidance Was Posted Against Scientists’ Objections

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A heavily criticized recommendation from the Centers for Disease Control and Prevention last month about who should be tested for the coronavirus was not written by C.D.C. scientists and was posted to the agency’s website despite their serious objections, according to several people familiar with the matter as well as internal documents obtained by The New York Times.

The guidance said it was not necessary to test people without symptoms of Covid-19 even if they had been exposed to the virus. It came at a time when public health experts were pushing for more testing rather than less, and administration officials told The Times that the document was a C.D.C. product and had been revised with input from the agency’s director, Dr. Robert Redfield.

But officials told The Times this week that the health department did the rewriting itself and then “dropped” it into the C.D.C.’s public website, flouting the agency’s strict scientific review process.

“That was a doc that came from the top down, from the H.H.S. and the task force,” said a federal official with knowledge of the matter, referring to the White House task force on the coronavirus. “That policy does not reflect what many people at the C.D.C. feel should be the policy.”

The document contains “elementary errors” — such as referring to “testing for Covid-19,” as opposed to testing for the virus that causes it — and recommendations inconsistent with the C.D.C.’s stance that mark it to anyone in the know as not having been written by agency scientists, according to a senior C.D.C. scientist who spoke on the condition of anonymity because of a fear of repercussions.

Adm. Brett Giroir, the administration’s testing coordinator and an assistant secretary at the Department of Health and Human Services, the C.D.C.’s parent organization, said in an interview Thursday that the original draft came from the C.D.C., but he “coordinated editing and input from the scientific and medical members of the task force.”

Over a period of a month, he said, the draft went through about 20 versions, with comments from Dr. Redfield; top members of the White House task force, Dr. Anthony Fauci and Dr. Deborah Birx; and Dr. Scott Atlas, President Trump’s adviser on the coronavirus. The members also presented the document to Vice President Mike Pence, who heads the task force, Admiral Giroir said.

He said he did not know why the recommendation circumvented the usual C.D.C. scientific review. “I think you have to ask Dr. Redfield about that. That certainly was not any direction from me whatsoever,” he said.

Dr. Redfield could not be reached for comment.

The question of the C.D.C.’s independence and effectiveness as the nation’s top public health agency has taken on increasing urgency as the nation approaches 200,000 deaths from the coronavirus pandemic and Mr. Trump continues to criticize its scientists and disregard their assessments.

A new version of the testing guidance, expected to be posted Friday, has also not been cleared by the C.D.C.’s usual internal review for scientific documents and is being revised by officials at Health and Human Services, according to a federal official who was not authorized to speak to reporters about the matter.

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Updated 2020-09-17T23:00:24.395Z

Similarly, a document, arguing for “the importance of reopening schools,” was also dropped into the C.D.C. website by the Department of Health and Human Services in July and is sharply out of step with the C.D.C.’s usual neutral and scientific tone, the officials said.

The information comes mere days after revelations that political appointees at H.H.S. meddled with the C.D.C.’s vaunted weekly reports on scientific research.

“The idea that someone at H.H.S. would write guidelines and have it posted under the C.D.C. banner is absolutely chilling,” said Dr. Richard Besser, who served as acting director at the Centers for Disease Control in 2009.

Dr. Thomas R. Frieden, director of the agency during the Obama administration, said, “H.H.S. and the White House writing scientifically inaccurate statements such as ‘don’t test all contacts’ on C.D.C.’s website is like someone vandalizing a national monument with graffiti.”

The vast majority of C.D.C. documents are still carefully created and vetted and are valuable to the public, but having politically motivated messages mixed in with public health recommendations undermines the institution, Dr. Frieden said. “The graffiti makes the whole monument look pretty bad,” he said.

The current guidelines on testing, posted on Aug. 24, said people without symptoms “do not necessarily need a test” even if they have been in close contact with an infected person for more than 15 minutes. Public health experts roundly criticized the C.D.C. for that stance, saying it would undermine efforts to contain the virus.

“Suggesting that asymptomatic people don’t need testing is just a prescription for community spread and further disease and death,” said Dr. Susan Bailey, president of the American Medical Association, which usually works closely with the C.D.C.

ImageRobert R. Redfield, the C.D.C. director, and Adm. Brett P. Giroir, the assistant secretary for health, at a Senate hearing on Wednesday.
Credit…Anna Moneymaker for The New York Times

Some experts also said the recommendation appeared to be motivated by a political impetus to make the number of confirmed cases look smaller than it is.

Dr. Redfield later tried to walk back the recommendation, saying testing “may be considered for all close contacts,” but his attempts only added to the confusion. The language on the C.D.C.’s website remained unchanged.

The Infectious Diseases Society of America, normally a close partner of the C.D.C., strongly criticized the recommendation on testing. “We’ve communicated that to the C.D.C. and H.H.S., but I have not seen any signs that they’re going to change it,” said Amanda Jezek, a senior vice president at the organization.

At a congressional hearing on Wednesday, Dr. Redfield said the agency was revising the recommendation and would post the revision, “I hope before the end of the week.” The revision was written by a C.D.C. scientist but was being edited on Thursday by the Department of Health and Human Services and the White House coronavirus task force, according to a federal official familiar with the matter.

Dr. Redfield also said at the Wednesday hearing that vaccines would not be widely distributed till next year and that face coverings were more effective than vaccines — assertions that Mr. Trump sharply criticized in a press briefing Wednesday evening, saying Dr. Redfield “made a mistake.”

The director has been described by C.D.C. employees and outsiders as a weak and ineffective leader who is unable to protect the agency from the administration’s meddling in its science or from the public’s increasing mistrust in the agency.

“It feels like a setup,” the C.D.C. scientist said, adding that many scientists within the agency feel it is being made to take the blame for the administration’s unpopular policies.

“C.D.C. scientists are running scared,” Scott Becker, chief executive of the Association of Public Health Laboratories, said. “There’s nothing they can do that gets them out of this blame game.”

The Centers for Disease Control has also often been criticized during the pandemic, for being too slow and cautious in issuing recommendations for dealing with the coronavirus. That’s partly because every document is cleared by at least one individual on multiple relevant teams within the agency to ensure the information is consistent with the “current state of C.D.C. data, as well as other scientific literature,” according to a senior agency scientist who spoke on the condition of anonymity.

In all, each document may be cleared by 12 to 20 people within the agency. “As somebody who reads them regularly and as somebody who has written things with C.D.C., I can tell you that the clearance process is painful, but it’s useful,” said Carlos del Rio, an infectious disease expert at Emory University. “It’s very detail oriented and very careful and they, quite frankly, improve the documents.”

At least eight versions of the current testing guidance were circulated within the agency in early August, according to officials. But staff scientists’ objections to the document went unheard. A senior C.D.C. official told the scientists, “We do not have the ability to make substantial edits,” according to an email obtained by The Times. The testing guidance was then quietly published on the agency’s website on Aug. 24.

Credit…Oliver Contreras for The New York Times

After the new guidance was published, media inquiries to the agency about its contents were directed to the Department of Health and Human Services, prompting speculation about its origins. C.D.C. scientists were asked to make sure other pages on the website were consistent with the new recommendations. And a “talking points” memo circulated within the agency on Sept. 1 instructed employees to say that the C.D.C. was involved in developing the new guidance “with suggested comments and edits shared back with HHS. and the White House Taskforce.”

That sort of instruction would not have been necessary had the document been written by the C.D.C. staff, according to experts familiar with the agency’s procedures. “Never seen that talking point before,” a C.D.C. scientist said.

The recommendation also asked people who “have attended a public or private gathering of more than 10 people (without widespread mask wearing or physical distancing)” to get tested only if they are “vulnerable.” The agency in fact recommends against people congregating in such groups, and its scientists avoid using the term “vulnerable” to describe at-risk groups, according to a C.D.C. scientist familiar with the agency’s procedures.

The guidance is also nested within the section intended for health care workers and labs, but addresses the general public and makes several references to “your health care provider.”

“We just looked so sloppy,” the scientist said. “That’s what kills me is it didn’t come from the inside.”

Experts who work closely with the C.D.C. said the mistakes were obvious.

“You’re used to reading Shakespeare and all of a sudden now you’re reading a tabloid,” Dr. del Rio said. “There was political pressure on C.D.C. in the past, but I think this is unprecedented.”

Sharon LaFraniere and Michael D. Shear contributed reporting.

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The Trump campaign celebrated a growth record that Democrats downplayed.

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The White House celebrated economic growth numbers for the third quarter released on Thursday, even as Joseph R. Biden Jr.’s presidential campaign sought to throw cold water on the report — the last major data release leading up to the Nov. 3 election — and warned that the economic recovery was losing steam.

The economy grew at a record pace last quarter, but the upswing was a partial bounce-back after an enormous decline and left the economy smaller than it was before the pandemic. The White House took no notice of those glum caveats.

“This record economic growth is absolute validation of President Trump’s policies, which create jobs and opportunities for Americans in every corner of the country,” Mr. Trump’s re-election campaign said in a statement, highlighting a rebound of 33.1 percent at an annualized rate. Mr. Trump heralded the data on Twitter, posting that he was “so glad” that the number had come out before Election Day.

The annualized rate that the White House emphasized extrapolates growth numbers as if the current pace held up for a year, and risks overstating big swings. Because the economy’s growth has been so volatile amid the pandemic, economists have urged focusing on quarterly numbers.

Those showed a 7.4 percent gain in the third quarter. That rebound, by far the biggest since reliable statistics began after World War II, still leaves the economy short of its pre-pandemic levels. The pace of recovery has also slowed, and now coronavirus cases are rising again across much of the United States, raising the prospect of further pullback.

“The recovery is stalling out, thanks to Trump’s refusal to have a serious plan to deal with Covid or to pass a new economic relief plan for workers, small businesses and communities,” Mr. Biden’s campaign said in a release ahead of Thursday’s report. The rebound was widely expected, and the campaign characterized it as “a partial return from a catastrophic hit.”

Economists have warned that the recovery could face serious roadblocks ahead. Temporary measures meant to shore up households and businesses — including unemployment insurance supplements and forgivable loans — have run dry. Swaths of the service sector remain shut down as the virus continues to spread, and job losses that were temporary are increasingly turning permanent.

“With coronavirus infections hitting a record high in recent days and any additional fiscal stimulus unlikely to arrive until, at the earliest, the start of next year, further progress will be much slower,” Paul Ashworth, chief United States economist at Capital Economics, wrote in a note following the report.

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Black and Hispanic workers, especially women, lag in the U.S. economic recovery.

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The surge in economic output in the third quarter set a record, but the recovery isn’t reaching everyone.

Economists have long warned that aggregate statistics like gross domestic product can obscure important differences beneath the surface. In the aftermath of the last recession, for example, G.D.P. returned to its previous level in early 2011, even as poverty rates remained high and the unemployment rate for Black Americans was above 15 percent.

Aggregate statistics could be even more misleading during the current crisis. The job losses in the initial months of the pandemic disproportionately struck low-wage service workers, many of them Black and Hispanic women. Service-sector jobs have been slow to return, while school closings are keeping many parents, especially mothers, from returning to work. Nearly half a million Hispanic women have left the labor force over the last three months.

“If we’re thinking that the economy is recovering completely and uniformly, that is simply not the case,” said Michelle Holder, an economist at John Jay College in New York. “This rebound is unevenly distributed along racial and gender lines.”

The G.D.P. report released Thursday doesn’t break down the data by race, sex or income. But other sources make the disparities clear. A pair of studies by researchers at the Urban Institute released this week found that Black and Hispanic adults were more likely to have lost jobs or income since March, and were twice as likely as white adults to experience food insecurity in September.

The financial impact of the pandemic hit many of the families that were least able to afford it, even as white-collar workers were largely spared, said Michael Karpman, an Urban Institute researcher and one of the studies’ authors.

“A lot of people who were already in a precarious position before the pandemic are now in worse shape, whereas people who were better off have generally been faring better financially,” he said.

Federal relief programs, such as expanded unemployment benefits, helped offset the damage for many families in the first months of the pandemic. But those programs have mostly ended, and talks to revive them have stalled in Washington. With virus cases surging in much of the country, Mr. Karpman warned, the economic toll could increase.

“There could be a lot more hardship coming up this winter if there’s not more relief from Congress, with the impact falling disproportionately on Black and Hispanic workers and their families,” he said.

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Ant Challenged Beijing and Prospered. Now It Toes the Line.

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As Jack Ma of Alibaba helped turn China into the world’s biggest e-commerce market over the past two decades, he was also vowing to pull off a more audacious transformation.

“If the banks don’t change, we’ll change the banks,” he said in 2008, decrying how hard it was for small businesses in China to borrow from government-run lenders.

“The financial industry needs disrupters,” he told People’s Daily, the official Communist Party newspaper, a few years later. His goal, he said, was to make banks and other state-owned enterprises “feel unwell.”

The scope of Mr. Ma’s success is becoming clearer. The vehicle for his financial-technology ambitions, an Alibaba spinoff called Ant Group, is preparing for the largest initial public offering on record. Ant is set to raise $34 billion by selling its shares to the public in Hong Kong and Shanghai, according to stock exchange documents released on Monday. After the listing, Ant would be worth around $310 billion, much more than many global banks.

The company is going public not as a scrappy upstart, but as a leviathan deeply dependent on the good will of the government Mr. Ma once relished prodding.

More than 730 million people use Ant’s Alipay app every month to pay for lunch, invest their savings and shop on credit. Yet Alipay’s size and importance have made it an inevitable target for China’s regulators, which have already brought its business to heel in certain areas.

These days, Ant talks mostly about creating partnerships with big banks, not disrupting or supplanting them. Several government-owned funds and institutions are Ant shareholders and stand to profit handsomely from the public offering.

The question now is how much higher Ant can fly without provoking the Chinese authorities into clipping its wings further.

Excitable investors see Ant as a buzzy internet innovator. The risk is that it becomes more like a heavily regulated “financial digital utility,” said Fraser Howie, the co-author of “Red Capitalism: The Fragile Financial Foundation of China’s Extraordinary Rise.”

“Utility stocks, as far as I remember, were not the ones to be seen as the most exciting,” Mr. Howie said.

Ant declined to comment, citing the quiet period demanded by regulators before its share sale.

The company has played give-and-take with Beijing for years. As smartphone payments became ubiquitous in China, Ant found itself managing huge piles of money in Alipay users’ virtual wallets. The central bank made it park those funds in special accounts where they would earn minimal interest.

After people piled into an easy-to-use investment fund inside Alipay, the government forced the fund to shed risk and lower returns. Regulators curbed a plan to use Alipay data as the basis for a credit-scoring system akin to Americans’ FICO scores.

China’s Supreme Court this summer capped interest rates for consumer loans, though it was unclear how the ceiling would apply to Ant. The central bank is preparing a new virtual currency that could compete against Alipay and another digital wallet, the messaging app WeChat, as an everyday payment tool.

Ant has learned ways of keeping the authorities on its side. Mr. Ma once boasted at the World Economic Forum in Davos, Switzerland, about never taking money from the Chinese government. Today, funds associated with China’s social security system, its sovereign wealth fund, a state-owned life insurance company and the national postal carrier hold stakes in Ant. The I.P.O. is likely to increase the value of their holdings considerably.

“That’s how the state gets its payoff,” Mr. Howie said. With Ant, he said, “the line between state-owned enterprise and private enterprise is highly, highly blurred.”

China, in less than two generations, went from having a state-planned financial system to being at the global vanguard of internet finance, with trillions of dollars in transactions being made on mobile devices each year. Alipay had a lot to do with it.

Alibaba created the service in the early 2000s to hold payments for online purchases in escrow. Its broader usefulness quickly became clear in a country that mostly missed out on the credit card era. Features were added and users piled in. It became impossible for regulators and banks not to see the app as a threat.

ImageAnt Group’s headquarters in Hangzhou, China.
Credit…Alex Plavevski/EPA, via Shutterstock

A big test came when Ant began making an offer to Alipay users: Park your money in a section of the app called Yu’ebao, which means “leftover treasure,” and we will pay you more than the low rates fixed by the government at banks.

People could invest as much or as little as they wanted, making them feel like they were putting their pocket change to use. Yu’ebao was a hit, becoming one of the world’s largest money market funds.

The banks were terrified. One commentator for a state broadcaster called the fund a “vampire” and a “parasite.”

Still, “all the main regulators remained unanimous in saying that this was a positive thing for the Chinese financial system,” said Martin Chorzempa, a research fellow at the Peterson Institute for International Economics in Washington.

“If you can’t actually reform the banks,” Mr. Chorzempa said, “you can inject more competition.”

But then came worries about shadowy, unregulated corners of finance and the dangers they posed to the wider economy. Today, Chinese regulators are tightening supervision of financial holding companies, Ant included. Beijing has kept close watch on the financial instruments that small lenders create out of their consumer loans and sell to investors. Such securities help Ant fund some of its lending. But they also amplify the blowup if too many of those loans aren’t repaid.

“Those kinds of derivative products are something the government is really concerned about,” said Tian X. Hou, founder of the research firm TH Data Capital. Given Ant’s size, she said, “the government should be concerned.”

The broader worry for China is about growing levels of household debt. Beijing wants to cultivate a consumer economy, but excessive borrowing could eventually weigh on people’s spending power. The names of two of Alipay’s popular credit functions, Huabei and Jiebei, are jaunty invitations to spend and borrow.

Huang Ling, 22, started using Huabei when she was in high school. At the time, she didn’t qualify for a credit card. With Huabei’s help, she bought a drone, a scooter, a laptop and more.

The credit line made her feel rich. It also made her realize that if she actually wanted to be rich, she had to get busy.

“Living beyond my means forced me to work harder,” Ms. Huang said.

First, she opened a clothing shop in her hometown, Nanchang, in southeastern China. Then she started an advertising company in the inland metropolis of Chongqing. When the business needed cash, she borrowed from Jiebei.

Online shopping became a way to soothe daily anxieties, and Ms. Huang sometimes racked up thousands of dollars in Huabei bills, which only made her even more anxious. When the pandemic slammed her business, she started falling behind on her payments. That cast her into a deep depression.

Finally, early this month, with her parents’ help, she paid off her debts and closed her Huabei and Jiebei accounts. She felt “elated,” she said.

China’s recent troubles with freewheeling online loan platforms have put the government under pressure to protect ordinary borrowers.

Ant is helped by the fact that its business lines up with many of the Chinese leadership’s priorities: encouraging entrepreneurship and financial inclusion, and expanding the middle class. This year, the company helped the eastern city of Hangzhou, where it is based, set up an early version of the government’s app-based system for dictating coronavirus quarantines.

Such coziness is bound to raise hackles overseas. In Washington, Chinese tech companies that are seen as close to the government are radioactive.

In January 2017, Eric Jing, then Ant’s chief executive, said the company aimed to be serving two billion users worldwide within a decade. Shortly after, Ant announced that it was acquiring the money transfer company MoneyGram to increase its U.S. footprint. By the following January, the deal was dead, thwarted by data security concerns.

More recently, top officials in the Trump administration have discussed whether to place Ant Group on the so-called entity list, which prohibits foreign companies from purchasing American products. Officials from the State Department have suggested that an interagency committee, which also includes officials from the departments of defense, commerce and energy, review Ant for the potential entity listing, according to three people familiar with the matter.

Ant does not talk much anymore about expanding in the United States.

Ana Swanson contributed reporting.

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