From her office in the West Wing, Dr. Birx serves as a link between federal agencies the Departments of Defense, Homeland Security, Health and Human Services, and others engaged in the response.

She is also the point of contact for state and local officials, and oversees the drafting of detailed reports offering guidance to the states. She briefs Mr. Pence weekly and the president at least once a week, and must contend with competing forces on the task force, which includes Dr. Anthony S. Fauci, the governments top infectious disease expert, and Dr. Robert R. Redfield, the C.D.C. director. She is often the only woman in the room.

In interviews with AIDS activists and public health experts, Dr. Birx drew unfavorable comparisons with the outspoken Dr. Fauci, in whose lab she trained. Mr. Gonsalves, who has long known both of them, said he wrote in March to Drs. Birx, Fauci and Redfield, as well as Adm. Brett P. Giroir, who oversees coronavirus testing, complaining that they were parroting the president. Only Dr. Fauci replied.

Debbie is now in the position where shes saying to the emperor that those new clothes look fantastic, Mr. Gonsalves said.

But inside the White House, aides refer to Dr. Birx as Dr. Doom for her efforts to temper the presidents positive spin. And she and Dr. Fauci are not in the same situation. Dr. Fauci, 79, is nearing the end of his career and is a civil servant, which frees him to speak his mind. Dr. Birx, 64, is a political appointee who serves at the pleasure of the president.

Shes one of the hardest workers, and shes devoted to trying to get this pandemic under control, Dr. Fauci said in an interview Tuesday night.

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With Old Allies Turning Against Her, Birx Presses On Against the Coronavirus - The New York Times