February 26, 2020

Senator Warren Raises Concerns with Federal Agencies over Troubling Decision-Making Process, Citing “Confusion and Disagreement” During Evacuation of Americans with Coronavirus from Diamond Princess Cruise Ship in Japan

State Department and HHS officials reportedly overruled CDC recommendations; “[T]he leadership of all the relevant agencies [should] have a clear, responsive, and integrated process for responding to new circumstances and incorporating expert advice”

Washington, D.C. – United States Senator Elizabeth Warren (D-Mass.), a member of the U.S. Senate Health, Education, Labor, and Pensions (HELP) Committee, today sent a letter to Secretary of State Michael Pompeo, Health and Human Services (HHS) Secretary Alex Azar, and Centers for Disease Control and Prevention (CDC) Director Robert Redfield raising concerns over reports that appeared to show confusion and disagreement between federal officials earlier this month when State Department and HHS officials overruled CDC recommendations during the evacuation of American citizens with coronavirus from Japan. The letter requests information on this episode and the administration’s process for making ongoing public health decisions regarding coronavirus.

“Coronavirus poses numerous complex and challenging public health problems, and the Administration has been—and will continue to be—forced to make many difficult public health decisions as officials seek to prevent a nationwide outbreak in the coming days and weeks,” Senator Warren wrote. “These questions are particularly urgent given the announcement yesterday by a top CDC official that ‘we expect we will see community spread [of coronavirus] in the United States.’”

One of the largest coronavirus outbreaks outside of China to date occurred on the Diamond Princess cruise ship, with more than 691 passengers infected and three deaths. After passengers on the ship began testing positive for the virus, the ship was held in quarantine in Yokohama, Japan for two weeks. On February 17, 2020, the State Department began the evacuation of 328 Americans on board.

Once the evacuation process was underway, 14 of the Americans subsequently tested positive for the virus. Reports indicate that the CDC warned that allowing them to fly home on the same flight as the other passengers would put the uninfected passengers and crew at risk of contracting the virus, and CDC officials recommended that the infected passengers remain quarantined in Japan. However, State Department and senior HHS officials reportedly overruled the CDC’s recommendations and transported the infected passengers on the evacuation flight. In addition, CDC officials reportedly refused to be mentioned in the news release about the decision because “CDC did weigh in on this and explicitly recommended against it.”

“I am not in position to determine if the decision to evacuate the 14 Americans that were infected with coronavirus with others was correct. But the process by which this decision was reportedly made is troubling,” wrote Senator Warren. “As the global coronavirus public health emergency continues, it will be essential for the leadership of all the relevant agencies to have a clear, responsive, and integrated process for responding to new circumstances and incorporating expert advice.”

Senator Warren has asked the agencies to respond to her questions no later than March 11, 2020. She asked the agencies to clarify the decision-making process and chain of command, including under what circumstances and by whom CDC recommendations can be overruled; the current protocol for future quarantine, treatment, and evacuation of Americans who contract the coronavirus while traveling abroad; and the results of any evaluation of the Diamond Princess evacuation.

Senator Warren has spent over seven years in the U.S. Senate fighting to keep families across the Commonwealth and the country safe. Since the beginning of the Novel Coronavirus outbreak, she has worked to ensure that the Trump Administration is effectively responding to the outbreak and has the resources needed to address this public health threat, including calling for the appointment of a new National Security Council global health expert in May 2018 and again on February 13, 2020. Read more about her oversight work here.