By AAMER MADHANI and JULIE PACE Associated Press
WASHINGTON (AP) — When the nation's top infectious disease doctor warned it could be risky for schools to open this fall, President Donald Trump said that was unacceptable.
When experts from the Centers for Disease Control and Prevention produced a roadmap for how Americans could slowly get back to work and other activities, Trump's top advisers rejected it.
And when the Food and Drug Administration warned against taking a malaria drug to combat COVID-19 except in rare circumstances, Trump asked his doctor for it anyway.
The coronavirus pandemic has thrown into stark relief the extent of Trump's disregard for scientific and medical expertise, even when the safety of millions of Americans or his own personal health is on the line. In public briefings and private meetings, he's challenged the very experts his administration has pulled together to address the crisis, often preferring to follow his own instincts or the advice of allies in the business world or conservative media.
In doing so, Trump appears to be disregarding what has long been considered the special responsibility of the American president to set an example for the nation, unconcerned that taking a personal risk could lead millions of others looking to the White House for guidance to do the same.
"He forgets that he's president and that what he does and says, people listen to and model themselves on that," said Lawrence Gostin, a public health expert at Georgetown University.
Health professionals' concerns became particularly acute this week following Trump's surprise revelation that he was taking hydroxychloroquine, a drug he and several of his allies have been pushing despite warnings from experts. The FDA cautioned earlier this year that the drug should only be taken for COVID-19 in a hospital or research setting because of potentially fatal side effects.
The president is not in a hospital. He is not participating in a clinical trial. And he doesn't have the coronavirus. Instead, he told reporters he was taking the drug as a "line of defense" after a pair of White House staffers contracted the virus.
Addressing the criticism of his decision on Tuesday, the president appeared undeterred. He said he was making an "individual decision" and suggested one of the studies raising concerns about the drug was a personal attack.
"It was a Trump enemy statement," he said.
David Axelrod, who served as a senior adviser to President Barack Obama, said Trump often appears to relish the opportunity to challenge the guidance of the government without recognizing that he is the head of that same government.
"He's acting as the leader of a populist movement that resents the things government is asking people to do," Axelrod said.
It's not new. Trump has a history of flouting scientific and medical expertise, both as a private citizen and as president.
He's questioned whether childhood vaccines cause autism, despite ample evidence to the contrary. He's played down dire warnings about the impact of climate change on the environment and public health, pulling the U.S. out of a global accord aimed at reduced emissions and rolling back regulations that would do the same. When he stepped out onto a White House balcony in 2017 to view a solar eclipse, he ignored a well-known warning from scientists and looked directly at the sun without protective glasses.
Ross Baker, a Rutgers University political scientist, said Trump's dismissive view of scientific expertise echoes the suspicion many of the president's supporters have of "elites" in politics and other fields.
"His attitude has been 'I know more than the generals. I know more than the economists.' Now, it's 'I know more than the scientists,'" said Baker, who served as an adviser to former Republican Sen. Chuck Hagel and Democrat Sen. Patrick Leahy.
While some of Trump's scientific skepticism may well be political strategy, the COVID-19 pandemic has raised the stakes. The virus spread swiftly across the world, leaving many Americans uncertain about how to protect themselves and looking to their leaders for best practices on everything from testing to treatment, and now for guidance on how to begin resuming daily activities.
But the messages from the White House have often been muddled. Trump has repeatedly pushed for a more aggressive economic opening than many of his public health advisers and has used his presidential megaphone to amplify unproven, and sometimes dangerous, methods for combating the virus.
At times, that approach has rattled his own advisers, most notably after he mused during a televised briefing that ingesting disinfectant might fight off the virus. That statement prompted an extraordinary outcry, with the manufacturers of household cleaners issuing statements warning against following Trump's suggestions.
The president's disclosure that he is taking hydroxychloroquine set off a similar scramble. White House officials urged Americans to follow the recommendations of their doctors, while many doctors said taking the drug could carry significant risk.
"I would not recommend taking this drug unless you are hospitalized and your doctor thinks it makes sense or you're in a clinical trial," said Dr. Radha Rajasingham, the principal investigator of a hydroxychloroquine prophylaxis study underway at the University of Minnesota. She added, "It is not helpful to the American people to use it in this context and that worries me."
One potential bright spot for those concerned the public will follow Trump's lead: Recent polling suggests most Americans don't view the president as a reliable source of information on the pandemic.
Just 23% of Americans said they have a high level of trust in what the president is telling the public about the virus, according to an April survey from The Associated Press-NORC Center for Public Affairs Research. Even some Republicans took a dim view of the president's reliability: 22% said they had little or no trust in what the president says about the COVID-19 outbreak.