White House officials are discussing whether to replace Health and Human Services Secretary Alex Azar as frustrations have grown over his handling of the coronavirus crisis earlier this year, as well as over his removal last week of a top vaccine official in his agency, which created an uproar.

Several top White House aides are discussing Azar’s removal and have mused over possible successors, but President Trump has not weighed in, said five people familiar with the talks who spoke on the condition of anonymity to be candid. It remains unclear whether the president will want to replace his top health official amid a pandemic, because it could signal more chaos and turmoil in the administration’s response, which has come under repeated fire. More than 54,000 Americans have died of covid-19, the disease the novel coronavirus causes, and more than 950,000 U.S. cases had been reported as of Sunday.

During the past several weeks, Azar has rarely appeared at the daily White House coronavirus news briefings and has been largely sidelined from the response. He oversaw that effort until Feb. 26, when he was replaced by Vice President Pence amid anger over the continued lack of coronavirus testing and conflicting messages from health officials about the threat of the virus. His agency, however, is still responsible for crucial aspects of the pandemic response, such as leading the search for treatments and vaccines and distributing $100 billion worth of relief to hospitals that was allocated by Congress.

One senior administration official with knowledge of the discussions said Trump has no deep affection for Azar but is unlikely to change secretaries as the coronavirus continues to rage. There is also concern about having a nomination fight in an election year on an issue — health care — that many Trump advisers see as a political weakness. Spokesmen for the White House and HHS denied Azar’s job was in jeopardy.

“The Department of Health and Human Services, under the leadership of Secretary Azar, continues to lead on a number of the President’s priorities. Any speculation about personnel is irresponsible and a distraction from our whole-of-government response to covid-19,” White House spokesman Judd Deere said in a statement.

“Secretary Azar is busy responding to a global, public health crisis and doesn’t have time for palace intrigue,” HHS spokeswoman Caitlin Oakley said in a statement.

The Wall Street Journal and Politico first reported discussions about Azar’s possible removal on Saturday.

Trump and White House aides were frustrated at recent reports that Azar’s efforts to warn the president about the coronavirus in January went unheeded. On April 12, Trump tweeted, “I was criticized for moving too fast when I issued the China ban, long before most others wanted to do so. @SecAzar told me nothing until later.”

Earlier this month, the White House installed Michael Caputo, a staunch Trump ally, to run communications at the agency.

Azar removed Rick Bright as director of the Biomedical Advanced Research and Development Authority last week and reassigned him to a narrower role at the National Institutes of Health. Trump grew especially angry on Wednesday after Bright issued a statement through his attorneys that he had been pushed out of his job in retaliation for resisting efforts to “provide an unproven drug on demand to the American public,” referencing the anti-malarial medications that Trump has repeatedly pushed. Three senior administration officials said discussions about Bright’s removal had been underway for months at HHS because of internal conflicts and his job performance.

The Bright saga caught Trump and White House officials off guard, three senior administration officials said, because Azar told them he was promoting Bright. Aides were angry at being blindsided by the fallout.

“Dr. Rick Bright will transfer the skills he has applied as Director of the Biomedical Advanced Research and Development Authority to the National Institutes of Health, as part of a bold plan to accelerate the development and deployment of novel point-of-care testing platforms,” HHS said about Bright’s transfer last week.

HHS disputed Bright’s stated reasons for leaving, noting he requested the authorization from the Food and Drug Administration that had enabled officials to add the medications to the national stockpile of emergency medical equipment and medications.

On Thursday, Bright’s attorneys said he planned to file a whistleblower complaint. Rep. Anna G. Eshoo (D-Calif.), chairwoman of the House Energy and Commerce health subcommittee, said last week that she planned to hold hearings on Bright’s departure and hear from Azar, as well as Robert Kadlec, Bright’s boss and assistant secretary for preparedness and response at HHS.

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