Republicans say Mandy Cohen shouldn’t lead the CDC. Are their claims about her true?

Dr. Mandy Cohen, who led North Carolina’s Department of Health and Human Services through most of the COVID-19 pandemic, has come under scrutiny after it was announced she will be President Joe Biden’s next pick for director of the Centers for Disease Control and Prevention.

On Friday, the White House announced Cohen’s nomination as the next CDC director.

To some, Cohen has the chops for the job.

“I think she’ll be terrific. This is a challenging time for the nation’s public health and the CDC in particular,” said Mark McClellan, founding director of the Duke-Margolis Center for Health Policy, who said he worked with Cohen while she led DHHS during the pandemic.

Cohen’s “got the background and the credibility and the trust and she’s worked across both sides of the aisle in North Carolina on COVID response and stuff like reopening North Carolina’s schools much earlier than the rest of the country and doing it safely, communicating effectively with the public about issues in COVID, and then other public health and health care challenges,” McClellan said.

Cohen worked for more than a decade in women’s health services with the Department of Veterans Affairs and as chief operating officer and chief of staff at the federal Centers for Medicare and Medicaid Services under the Obama administration, among other roles.

She is also a policy, analysis and management graduate of Cornell University, and she received a medical degree from Yale School of Medicine and a master’s in public health from the Harvard School of Public Health. After her residency, she was an internal medicine physician.

But some say Cohen’s COVID-19 strategy was not ideal — that her approach was too political and not based on science.

Among her detractors are Sen. Ted Budd and Rep. Dan Bishop, who alongside 26 other Republicans in Congress — many from the ultra-conservative House Freedom Caucus — sent a letter to Biden opposing Cohen’s selection.

They said that Cohen, while serving as DHHS secretary, “politicized science, disregarded civil liberties, and spread misinformation about the efficacy and necessity of COVID vaccinations and the necessity of masks.”

Are Republicans’ claims about her qualifications true? We fact-checked some of what they said here.

COVID-19 restrictions on schools

Claim: “As Secretary of the North Carolina Department of Health and Human Services, Dr. Cohen was a proponent of unnecessary, unscientific COVID restrictions on school children, stating in July 2021 that ‘Schools with students in K-8th grade should require all children and staff to wear masks indoors, regardless of vaccination status,‘” the letter says.

Early in the pandemic, Gov. Roy Cooper, with Cohen leading the state’s COVID-19 strategy, did require students to mask, regardless of vaccination status.

Officials said it was because most school-age children in K-8 were not eligible for the vaccine at the time, as previously reported by The News & Observer.

CDC guidance said fully vaccinated students and teachers did not have to wear face masks in school, but it recommended continued masking of unvaccinated people in schools, which included all students in elementary schools, The N&O reported.

In February 2022, North Carolina eased COVID-19 requirements, citing widespread access to the COVID-19 vaccine.

Did Cohen threaten schools with legal action?

Claim: “After a North Carolina school district followed the science by declining to institute unscientific mask mandates and voted with an overwhelming majority to end ‘contact tracing’ and curtail other unproven and largely hysterical quarantine policies,” Cohen “threatened” legal action against the district, the letter said.

On Sept. 13, 2021, the Union County school board, which did not require masks in school, voted to allow quarantined students back into class as long as they were not showing symptoms or testing positive for COVID-19. The board also voted to end contact tracing.

Shortly after the motion, in a letter addressed to the board, Cohen wrote that current law said “isolation is required for all presumptive or confirmed cases of COVID-19,” and that “quarantine is required for an individual who has been a close contact ... of someone who is determined positive with COVID-19” with some exceptions, including individuals who were fully vaccinated, who had a COVID-19 infection in the previous 90 days or “when face masks are being used appropriately by both the student with COVID-19 and the potentially exposed student.”

Because of this, Cohen requested the board rescind the motion and urged Union County Public Schools to adopt state recommendations on the pandemic or “at the very least, to reimpose the requirements to cooperate with local public health officials in identifying individuals exposed to COVID-19 as well as exclude students subject to isolation and quarantine measures.”

“If Union County public schools do not take such steps by September 17th, legal action may be required to protect the public’s health,” Cohen wrote in the letter.

Shortly after the letter, the district modified its policy, reinstating but reducing quarantine times for students who hadn’t tested positive.

Were Cohen’s decisions based on science?

Claim: “While Dr. Cohen claims to have acted on scientific data, her account of her decision-making during the pandemic indicates that she merely arbitrarily copied her friends’ actions in similar positions of power, without considering scientific evidence or the decisions of elected officials.”

Cohen did confer with her peers on decision-making, but this claim needs context.

To back their claim, letter authors referenced things Cohen said during a Duke University seminar.

“For instance, she recounted a conversation with the Secretary of Health and Human Services in Massachusetts, the person whom Dr. Cohen claimed she ‘called the most’ for advice on COVID policy,” the Republicans’ letter said.

The authors quoted Cohen, who was answering a question at the seminar about state-to-state relationships during COVID-19.

“I think the CDC did facilitate some more formal across-state-lines learning,” she said. “... I’d say at the leadership level, right, my counterparts in other states, a lot of our sharing of knowledge really rested a lot on personal relationships. So I would call — probably the person I called most was the Secretary of Health and Human Services in Massachusetts.”

“I’d be like, ‘So when are you going to think about lightening up on masks?’ (She’d be like) ‘Next Monday’ and I’d be like ‘Okay! Next Monday.’”

When COVID-19 hit in 2020, there was a worldwide scramble to pinpoint the best courses of action with snags due to bottlenecked resources and limited communication and research.

In an interview with The N&O in 2020 during the pandemic, Cohen said the “science and data” she and Cooper mentioned so often in news conferences came from hundreds of people, sometimes thousands.

Asked in 2020 if she would have done anything differently for the state’s response, Cohen said they were making decisions with the evidence and data they have at that moment.

“I feel very proud of the work that we’ve done,” Cohen said in September, 2020. “Are we perfect? No. We’re in a pandemic, we’re in a crisis.”

Was mask-wearing scientifically sound advice?

Claim: “In August 2020, Dr. Cohen publicly sported a Dr. Fauci-themed cloth mask, asserting that ‘face coverings are one of our strongest tools to slow the spread of COVID-19.’ This was despite scientific data showing that face coverings largely fail to stop the spread of COVID-19, including experts finding that ‘we continue to conclude that cloth masks and face coverings are likely to have limited impact on lowering COVID-19 transmission.’”

Overwhelming research data suggest mask-wearing helped stifle the spread of COVID-19.

Early in the pandemic, Cohen did wear a mask with Dr. Anthony Fauci’s face and assert it was a top tool against Covid-19. Fauci was then serving under former President Donald Trump as one of the lead members of the White House Coronavirus Task Force. He would later serve as Biden’s chief medical advisor.

Top public health organizations, including the CDC, struggled during the unprecedented pandemic, changing recommended guidelines as time progressed and new information was uncovered.

But a large body of research has demonstrated the effectiveness of masks, preferably combined with other preventive measures, such as hand-washing and physical distancing. Research also says N95 masks, which Cohen suggested using, give the most protection.

There is some research, such as the one cited by letter authors, that question the effectiveness of masks. But it acknowledged that more research could prove otherwise.

Republicans in their letter referenced an April 2020, study conducted by Lisa M. Brosseau and Margaret Sietsema, researchers affiliated with the University of Illinois at Chicago, dubbed “‘COMMENTARY: Masks-for-all for COVID-19 not based on sound data.” Researchers wrote that “the data supporting the effectiveness of a cloth mask or face covering are very limited” and that “wearing a cloth mask or face covering could be better than doing nothing, but we simply don’t know at this point.”

“Despite the current limited scientific data detailing their effectiveness, we support the wearing of face coverings by the public when mandated and when in close contact with people whose infection status they don’t know,” the research paper said. “However, we also encourage everyone to continue to limit their time spent indoors near potentially infectious people and to not count on or expect a cloth mask or face covering to protect them or the people around them.”

Dawn Baumgartner Vaughan contributed to this report.