Director of the Centers for Disease Control and Prevention Robert Redfield said April 22 that his statement on covid-19 in the fall is "accurately quoted." (Video: The Washington Post)

Robert Redfield, director of the Centers for Disease Control and Prevention, issued a candid warning Tuesday in a Washington Post interview: A simultaneous flu and coronavirus outbreak next fall and winter “will actually be even more difficult than the one we just went through,” adding that calls and protests to “liberate” states from stay-at-home orders — as President Trump has tweeted — were “not helpful.”

The next morning, Trump cracked down with a Twitter edict: Redfield had been totally misquoted in a cable news story summarizing the interview, he claimed, and would be putting out a statement shortly.

By Wednesday evening, Redfield appeared at the daily White House briefing — saying he had been accurately quoted after all, while also trying to soften his words as the president glowered next to him.

“I didn’t say that this was going to be worse,” Redfield said. “I said it was going to be more difficult and potentially complicated because we’ll have flu and coronavirus circulating at the same time.”

He added: “ ‘It’s more difficult’ doesn’t mean it’s going to be more impossible.”

The remarkable spectacle provided another illustration of the president’s tenuous relationship with his own administration’s scientific and public health experts, where the unofficial message from the Oval Office is an unmistakable warning: Those who challenge the president’s erratic and often inaccurate coronavirus views will be punished — or made to atone.

In a statement Wednesday, for example, Rick Bright — who until recently led the agency working on a coronavirus vaccine — said he was removed from his post for resisting efforts to “provide an unproven drug on demand to the American public.”

The result is a culture in which public health officials find themselves scrambling to appease and placate Trump, a mercurial boss who is focused as much on political and economic considerations as scientific ones.

An internal White House “Covid Mail” email address, for instance, exists to receive queries and suggestions from “friends and family” as well as random individuals — including doctors and business owners — from around the country who have reached out to White House officials. Those emails then get farmed out to the appropriate agencies — from the Food and Drug Administration to the Department of Health and Human Services — but some officials have privately worried that these missives receive priority and distract from more crucial scientific pursuits.

In another instance, Nancy Messonnier, the CDC’s director of the National Center for Immunization and Respiratory Diseases, was removed from her post as her agency’s coronavirus response head after sounding early alarms that Americans should begin preparing for “significant disruption” to their lives from a “severe illness.” The CDC held its last daily briefing on March 9 — a forum through which the nation would normally receive critical public health information — in part out of a desire not to provoke the president. 

“I think the main media briefing has been the task force briefing,” Redfield said in his interview with The Post on Tuesday, asked about the now-defunct CDC briefing. “A lot of the flow of the briefings probably had to do with where the response was grounded.”

And Surgeon General Jerome Adams seemed to go out of his way to lavish praise on Trump in an interview on CNN last month, claiming the 73-year-old president was “healthier than what I am” — a comment the 45-year-old physician later walked back in a number of tweets.

“We hope that science and the public health experts are leading the politicians, that their voices are in the foreground, and that the politicians follow their advice,” said Matt Seeger, who has researched crisis and emergency risk communication for the past 35 years at Wayne State University. “But in this case, the political agenda seems to be setting the agenda for the subject matter experts, which is exactly the opposite of the way we would expect to have this happen.”

Seeger, who has watched the daily White House briefings and said he has seen some of the administration’s health professionals speak in other forums, added that “it’s very clear the public health professionals have been self-censoring their statements.” They are, he added, “being very thoughtful and measured and probably adjusting their statements they don’t run the risk of running afoul of the political agenda. That’s very problematic.”

The White House dismissed the idea there was any undue pressure on public health officials from the president.

“Despite the media’s ridiculous efforts to somehow create distance between the president and his top health experts, it is simply fake news,” White House spokesman Judd Deere said in a statement. “President Trump has relied on and consulted with Dr. Adams, Dr. Birx, Dr. Fauci, Dr. Hahn, Dr. Redfield, and many others as he has confronted this unforeseen, unprecedented crisis and put the full power of the federal government to work to slow the spread, save lives, and place this great country on a data-driven path to opening up again.”

One senior administration official said Trump is also more receptive to the scientists and doctors in private than his public statements indicate. He is especially respectful of Deborah Birx, who oversees the administration’s coronavirus response, and has figured out a way to gently push back against the president, the official said.

The president has described Birx in positive terms to other confidants and always wants her at the briefing lectern, even as his opinion wavers on other task force members. She regularly spends several hours a day with the president and top aides, including Trump son-in-law and senior adviser Jared Kushner.

During Tuesday’s coronavirus news conference, Birx seemed hesitant to directly contradict Trump — who has made clear he is eager to see states begin to reopen their economy as quickly as possible — when asked about the plans by Georgia’s governor to reopen places like gyms and nail and hair salons.

“So if there’s a way that people can social distance and do those things, then they can do those things,” Birx said. “I don't know how, but people are very creative.”

During Wednesday’s task force meeting, a White House official said, the group discussed Georgia’s plans, as well as their concerns that the state’s proposal does not necessarily allow for safe and responsible distances to be maintained, or for good hygiene practices. And during the briefing Wednesday, Trump also addressed his concerns with the plan, claiming he told Georgia Gov. Brian Kemp (R) he strongly disagrees with his decision, which he called “too soon.”

This month, Anthony S. Fauci, an infectious disease expert and coronavirus task force member, began a briefing by offering a seeming apology for comments he had made to CNN’s Jake Tapper, in which he said that earlier mitigation efforts “could have saved lives.” Fauci said he had not intended to criticize Trump in responding to a hypothetical question with “the wrong choice of words,” but stressed that his clarification was entirely “voluntary.”

On Wednesday, asked if health professionals are unable to speak freely in Trump’s administration, Fauci dismissed the suggestion, saying, “Here I am.”

Many public health experts, however, say they are frustrated at what they see happening during the daily briefings, with the scientists being sidelined. According to a Post analysis, since the federal guidelines were announced on March 16, Trump has spoken 63 percent of the time, compared with Birx at 10 percent and Fauci at 5 percent.

“For most of us in the field, there’s frustration with the dance that we’re seeing,” said Jeanne Marrazzo, director of the Division of Infectious Diseases at the University of Alabama at Birmingham School of Medicine. “Most of us in the field are incredibly frustrated that they are being put in that position, but also incredibly grateful that they are willing to do it.”

Trump also regularly tells visitors to the Oval Office that he is in touch with doctors in New York — including his own — and many others he knows personally.

Guidelines that were drafted by the CDC and Federal Emergency Management Agency for safely reopening the country were watered down by White House officials before they were published, officials say. A person involved in the White House revision of the guidelines, however, said the goal was simply to make them understandable to the public.

Bright, the former director of the Biomedical Advanced Research and Development Authority who was moved to a narrower role at NIH this week, had expressed opposition to the way hydroxychloroquine was being politicized by the president and others in the administration, according to two people familiar with the discussions. Two senior administration officials said he repeatedly clashed with his boss, Robert Kadlec, the HHS assistant secretary for preparedness and response. One person familiar with the situation said Bright’s departure was long discussed among top HHS officials because of dissatisfaction with his job performance.

An adviser familiar with the virus response said the doctors were attempting to communicate with the country and follow crisis management guidelines. The president, on the other hand, this person said, “is trying to win a political battle.”

“He’s broken every rule of maintaining public trust, if you’re trying to do crisis communications for the entire public,” the adviser said, speaking anonymously to share a candid assessment. “I’m not sure that is what he’s trying to do.”

Health and Human Services Secretary Alex Azar, who once led the coronavirus response meetings as chairman of the task force, attends most in person but sometimes attends via phone or teleconference. An HHS spokeswoman said other officials also sometimes attend remotely.

The White House also recently installed Michael Caputo, a longtime Trump loyalist, to run communications at HHS.

 Within the agencies, less public-facing health officials are also struggling with the requests coming from the White House. Ideas passed along through the internal “Covid Mail” email system are routed largely to the health agencies. There have been messages to the FDA on testing, to the CDC on surveillance and epidemiology; and to NIH on vaccines.

Because the missives are coming from the White House, agency officials imbue them with a sense of urgency. “And then everyone has to drop what they’re doing,” a senior administration official said.

Philip Bump contributed to this report.

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