Until this month, Health and Human Services leaders had worked to limit Adams’ portfolio, worried that the voluble doctor would go off-script and fail to coordinate his messaging, said four officials in the health department who spoke on condition of anonymity. Adams also had been one of several officials who had fallen out of favor with HHS Secretary Alex Azar, who instead leaned on Brett Giroir, the assistant secretary for health and Adams’ boss, to carry out some responsibilities that might have otherwise gone to the surgeon general.

Meanwhile, the nation’s top doctor wasn’t added to the White House coronavirus task force until Vice President Mike Pence — Adams’ former boss as Indiana governor — took over the response from Azar three weeks ago. The high-profile, high-pressure job has placed a spotlight on an anesthesiologist who has long vowed that “health is apolitical and so am I.”

But part of his success has come by paralleling Trump’s own questionable claims about coronavirus and break from other public health officials.

Appearing on the March 2 edition of “Fox and Friends,” the surgeon general said he remained “convinced that more people are going to die by far from the flu than from coronavirus — not only in our country, but across the planet.” At the time, public health officials were urging Americans to stop comparing the new outbreak to the flu, noting that it minimized the risk of the far more deadly coronavirus, but Trump had used the comparison to allay concerns.

A spokesperson for Adams defended the comparison, telling POLITICO it “is not a case of either-or — both diseases can be deadly if we aren’t vigilant.”

Adams on March 8 also said on CNN that he and other Trump officials “actually feel pretty good that some parts of the country have contained [coronavirus], just like when you look at the flu.” The interview came after Trump and other advisers on March 6 claimed the virus was contained — which it is not, as the president has since conceded.

“That’s not under control for any place in the world,” Trump said on Monday.

In that same CNN interview, the 40-something Adams said that the 73-year-old Trump is “healthier than what I am” — a comment that drew snickers, given the roughly 30-year age gap. Adams’ allies said he was just responding to a question about the president’s relative risk for coronavirus and that the disease’s severity can be affected by pre-existing conditions, like Adams’ asthma.

Adams last weekend delivered another controversial message: He scolded the media and appeared to encourage journalists to change their focus.

“No more bickering, no more partisanship, no more criticism or finger-pointing,” the surgeon general told reporters assembled at the White House. “There will be plenty of time for that.” A spokesperson for Adams said that he was attempting to encourage the media “to help share the facts and basic precautions” about the outbreak.

Navigating the spotlight

Meanwhile, some of Adams’ warnings seem prescient, like a tweet last weekend urging hospitals to cancel all nonessential procedures to focus on coronavirus. While industry leaders privately called Adams alarmist and publicly wrote a letter of complaint, their thinking shifted amid the fast-moving outbreak, and on Wednesday, hospital groups agreed that they would scale back their services.

Adams also has used his platform to call for blood donations, enlist social media influencers, offer instructions on handwashing and hammer home the need for extensive social distancing — even beyond the 15-day time period previously announced by the White House.

"Fifteen days is likely not going to be enough to get us all the way through,” Adams said on Wednesday in an interview on NBC's "Today" show. “But we really need to lean into it now so that we can bend the curve in the next 15 days, and at that point we'll reassess.”

The White House praised Adams’ work on coronavirus. "President Trump has built an incredible team that is helping coordinate our whole-of-government response and that includes the Surgeon General," a spokesperson said in a statement to POLITICO, adding that Adams has also been leading on other priorities like fighting vaping, opioids and HIV.

Spokespeople for Azar and Adams said the two men have a good working relationship.

“Secretary Azar agrees the surgeon general has an important role in communicating with the American people, educating them on appropriate measures to protect against viral infections, and calming fears,” an HHS spokesperson said. “Surgeon General Adams has been involved with the secretary’s briefings for weeks, and the secretary has always been supportive of the surgeon general’s advisories and initiatives.”

The surgeon general also has fans across the aisle. Adams is, indeed, “one of the stars of the Trump administration,” said Rebekah Gee, a Democrat who worked with Adams before she stepped down as Louisiana health secretary in January. Gee also praised Adams’ apolitical approach, including in the current coronavirus crisis. “He is doing a good job.”

Lessons from an Indiana outbreak

Adams first came to national prominence when then-Indiana Gov. Pence tapped him in 2014 to be the state’s health commissioner. The two men soon worked closely together to tackle Indiana’s 2014-2015 HIV outbreak, which was among the nation’s worst in years — and was compounded by Pence’s decision not to take swift action.

The issue was further complicated because the HIV outbreak was most severe among people who injected drugs, and Adams had to overcome opposition, including from Pence, to begin a needle-exchange program that has since been credited with helping contain the disease.

“It's not always possible to get people to do what you think needs to be done by telling them what you think needs to be done,” said Joan Duwve, who served as Indiana’s chief medical officer and worked under Adams during the HIV outbreak. “I think that's probably where we were in the state of Indiana. … Jerome facilitated the necessary dialogue.”

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