WASHINGTON — It was the third week of August, the Republican National Convention was days away, and President Trump was impatient.
White House officials were anxious to showcase a step forward in the battle against the coronavirus: an expansion of the use of blood plasma from recovered patients to treat new ones. For nearly two weeks, however, the National Institutes of Health had held up emergency authorization for the treatment, citing lingering concerns over its effectiveness.
So on Wednesday, Aug. 19, Mr. Trump called Dr. Francis S. Collins, the director of the N.I.H., with a blunt message.
“Get it done by Friday,” he demanded.
It wasn’t done by Friday, and on Sunday, regulators at the Food and Drug Administration still had not finished a last-minute data review intended to ease N.I.H. doubts.
But on Sunday night, the eve of the convention, the president announced, with the F.D.A.’s approval, that plasma therapy would be available for wider use, and he declared that it could reduce deaths by 35 percent, vastly overstating what the data had shown about the benefits.
Mr. Trump’s call to Dr. Collins was a flash point in a pressure campaign by the White House to bend the nation’s public health agencies to his desire to show progress in the fight against a pandemic that has killed more than 192,000 people in the United States. And it was just one in a series of moments that have left scientists and regulators across the public health bureaucracy increasingly worried that the White House could exert greater pressure to approve a vaccine before Election Day, even in the absence of agreement on its effectiveness and safety.
On the night of the plasma announcement, Dr. Collins was told to show up at the White House, where he was given a coronavirus test and then shunted to the Roosevelt Room as Mr. Trump and others spoke to journalists in the briefing room.
There, Dr. Collins and Dr. Peter Marks, one of the top regulators at the Food and Drug Administration and the person most directly responsible for maintaining the independence and scientific rigor of the vaccine approval process, watched helplessly as the president and other top administration officials oversold plasma’s effectiveness, creating a public relations debacle that reverberated for days.
Dr. Collins left the White House after the announcement. But Dr. Marks, who had pushed for the plasma approval, was escorted to the Oval Office to spend a few minutes with Mr. Trump and his top aides, who were celebrating with cupcakes with white icing. In an interview on Friday, Dr. Marks said he was “a little bit in a state of shock” to find himself there being thanked by the president for his work on the plasma approval.
Although he described it as “a brief interaction that really didn’t have any substance,” health officials who had heard about the encounter said they feared it could create the impression that the guardrails between politics and science were being further eroded at a time when the public is already concerned about political pressure in assessing the safety of vaccines and treatments.
Some of those present were taken aback when Mr. Trump, who a day earlier had tweeted about a “deep state” at the Food and Drug Administration blocking quick approvals of treatments and vaccines to hurt him politically, jokingly asked whether Dr. Stephen M. Hahn, the F.D.A. commissioner, was doing a good job.
------- “There is no fate that cannot be surmounted by scorn.” -Albert Camus