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WASHINGTON -- Political appointees at the Department of Health and Human Services have repeatedly asked the Centers for Disease Control and Prevention to revise, delay and even scuttle weekly reports on the coronavirus that they believed were unflattering to President Donald Trump.

Current and former senior health officials with direct knowledge of phone calls, emails and other communication between the agencies said Saturday that meddling from Washington was turning widely followed and otherwise apolitical guidance on infectious disease, the Morbidity and Mortality Weekly Reports, into a political loyalty test, with career scientists framed as adversaries of the administration.

They confirmed an article in Politico on Friday night that the CDC's public morbidity reports, which one former top health official described Saturday as the "holiest of the holy" in agency literature, have been targeted for months by senior officials in the health department's communications office. It is unclear whether any of the reports were substantially altered, but important federal health studies have been delayed because of the pressure.

The reports are written largely for scientists and public health experts, updating them on trends in all infectious diseases, covid-19 included. They are guarded so closely by agency staff members that political appointees see them only just before they are published. Health department officials have typically received notice of just the reports' titles.

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Michael Caputo, a former Trump campaign official installed by the White House in April as the top department spokesman, said Saturday that the person most involved in reshaping the Morbidity and Mortality Weekly Reports has been Paul Alexander, an assistant professor of health research at McMaster University in Canada and an adviser whom Caputo hired to help him on the science of the pandemic.

"He digs into these MMWRs and makes his position known, and his position isn't popular with the career scientists sometimes," Caputo said. "That's called science. Disagreement is science. Nobody has been ever ordered to do anything. Some changes have been accepted, most have been rejected. It's my understanding that that's how science is played."

But Caputo and Alexander appeared to view the reports, which have presented dire new findings about the spread of the virus, as incompatible with the Trump administration's push to move beyond the pandemic and present the country as on the upswing, officials said.

The New York Times interviewed four current and former federal health officials Saturday with direct knowledge of efforts to alter the weekly reports. They spoke on condition of anonymity to be frank on internal deliberations at the Department of Health and Human Services.

In an email obtained by Politico and confirmed by a person with direct knowledge of them, Alexander accused CDC scientists of trying to "hurt the president" with the reports, which he referred to as "hit pieces on the administration." Alexander asked Dr. Robert Redfield, the CDC director, to edit reports that had already been published, which he believed overstated the risks of the virus for children and undermined the administration's efforts to encourage schools to reopen.

Caputo and Alexander also tried to stop the publication of a report -- issued last week after a delay -- on use of the malaria drug hydroxychloroquine, an unproven treatment that Trump and conservative allies have heralded and used as a kind of litmus test of resistance to scientific consensus. In discussions with the CDC, they questioned the political beliefs of the report's authors.

The political involvement "undermines the credibility of not only the MMWR but of the CDC. And the CDC's credibility has been tarnished throughout COVID already," said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University who sits on the external editorial board of the Morbidity and Mortality Weekly Reports.

"The MMWR had an unblemished reputation as being accurate, objective and science-based, free from political influence," he said.

The meddling from Washington has concerned Redfield, who often pushed back when Caputo called to pester him about the morbidity reports, according to a former senior government health official with direct knowledge of the conversations.

The CDC earlier this year was first asked for titles and synopses of the reports before their publication. Agency officials were then asked for full drafts, a request that Redfield resisted. Caputo and his aides "wanted to add caveats and add commentary," according to the official.

Alexander at one point demanded the CDC stop publishing the reports until he had the ability to review and edit them in their entirety.

One federal health official emphasized that while the CDC now sends portions of draft weekly reports to the Health and Human Services Department, their publication is not conditioned on department approval. Still, the official said, the draft reports are returned with specific critiques from Alexander and demands for revisions.

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