(CNN) Questions about the US coronavirus death count have taken hold inside the White House, officials familiar with the matter say, as President Donald Trump and his aides discuss whether figures used by administration to determine mortality rates and death projections are reliable indicators for plotting a path forward.
As nationwide case numbers show a steady decrease, Trump and some of his aides have begun questioning whether deaths are being over-counted, according to people familiar with the matter, even as the President publicly attests to the accuracy of the numbers.
The top medical expert on the White House's coronavirus task force, Dr. Anthony Fauci, has said the opposite could be true: that coronavirus deaths are being undercounted as people die at home without going to hospital.
But inside the West Wing, officials said there have been steady doubts about coronavirus figures arriving from the US Centers for Disease Control and Prevention, either because they are behind or potentially skewed. In meetings of the White House task force, senior officials have raised questions about how the agency is compiling and tracking its data.
The death count questions illustrate the degree to which Trump and his allies have begun to scrutinize the data and advice emerging from government sources: Death counts are questioned, models are doubted, recommendations are debated and discarded and medical experts -- even those widely trusted by the American people -- are viewed with suspicion.
As the President agitates for a national reopening and looks ahead to November's election, his allies and even some of his own advisers have sown distrust in the institutions and data which underpin his coronavirus response.
Trump himself has waded only intermittently into the fray, leaving his supporters in Congress, the White House and conservative media to plant seeds of skepticism in government facts and figures. But he hasn't tamped down on the efforts and, through his actions, has largely discounted the guidelines set forth by his own experts.
The phenomenon is hardly new for Trump, whose presidency has been marked by a sidelining of experts and facts. But the efforts underway now appear designed to advance national reopening efforts that Trump believes will revive the economy and with it his reelection prospects, even as some public health experts warn it could lead to a new resurgence of the virus if executed too quickly.
The questions about the coronavirus death count have contributed to a growing sense of distrust between the White House and the CDC, which has largely been sidelined amid the largest public health crisis in decades. The White House task force is still weighing the agency's detailed guidelines for opening specific types of businesses after an initial draft was sent back.
Ongoing discussions about the accuracy of the death numbers have centered on whether they are "helpful" in formulating policy, one official said, adding that some people at the relevant agencies are "uncomfortable" with the fluctuations in the models.
The death count numbers have been subject to revisions and changes, including after the CDC issued new guidelines last month saying it was "acceptable to report COVID-19 on a death certificate as 'probable' or 'presumed,' " when a definitive diagnosis can't be made. After the new guidelines were issued, an additional 3,700 deaths were reported in New York City.
Trump seemed to bristle at the new numbers, appearing to accuse the city of padding its death numbers by counting deaths that could have been caused by other ailments.
"Rather than heart attack, they say heart attack caused by this," he said.
Later, however, he backed off, saying the US death counts are "very, very, highly accurate."
He appeared to deny any efforts to discount the US death count even as he accused other countries of low-balling their own mortality numbers.
"Our numbers are, essentially certified numbers," the President said earlier this month. "They're individual hospitals they're putting out the numbers. I don't imagine there'd be a very big variation."
Trump has been less enthusiastic about the various models that have shown US deaths rising or falling based on various mitigation factors.
"These models have been so wrong from day one," he told ABC News in an interview this month, voicing a level of skepticism on both official and unofficial models that has existed among his advisers for weeks.
Even Dr. Deborah Birx, the White House coronavirus response coordinator, has raised concerns with how the CDC has collected and reported some of its data, including death counts, according to officials familiar with the matter.
The Washington Post first reported last week that Birx told colleagues: "There is nothing from the CDC that I can trust," a sentiment multiple officials said has pervaded some task force meetings when information from the Atlanta-based agency is presented.
Others inside the administration's coronavirus effort have suggested the death count is being undercounted. In congressional testimony on Tuesday, Fauci told lawmakers that he and many public health experts believed the number of deaths was higher than the roughly 80,000 currently reported.
"Most of us feel that the number of deaths are likely higher than that number, because given the situation particularly in New York City when they were really strapped with a very serious challenge to their health care system, that there may have been people who died at home who did have Covid who are not counted as Covid because they never really got to the hospital," he said, responding to a question from Sen. Bernie Sanders of Vermont.
"I think you are correct that the number is likely higher," Fauci told Sanders. "I don't know exactly where it sits higher, but almost certainly is higher."
Fauci said counting the number of dead in hard-hit areas is a major challenge for public health experts.
It was the latest example of Fauci offering a blunt assessment of the coronavirus outbreak that didn't necessarily line up with the rosier outlook from the White House. Elsewhere in his testimony on Tuesday, Fauci warned that states would face "serious" consequences if they reopen ahead of the administration's recommendations, even though Trump has encouraged states that haven't met that criteria to begin lifting restrictions.
During the most heated exchange of the hearing -- at which Fauci appeared remotely -- one of Trump's strongest allies on Capitol Hill, Republican Sen. Rand Paul, intimated the top infectious disease expert had become overly powerful.
"I don't think you're the end-all. I don't think you're the one person who gets to make a decision," Paul said. "We can listen to your advice, but there are people on the other side saying there's not going to be a surge and that we can safely open the economy."
Fauci took exception, saying he was only one voice of many and that he was only offering public health advice. Some conservative lawmakers rushed to his defense, including Rep. Liz Cheney, who tweeted Fauci "is one of the finest public servants we have ever had" whose "expertise and judgment" are needed to defeat the virus.
But other Trump allies amplified Paul's concerns -- including the entire prime-time lineup on Fox News, the President's favorite channel.
"This guy, Fauci, may be even more off-base than your average epidemiologist," Tucker Carlson said at 8 p.m. ET. Fauci "seems to favor what the Democrats want and that is massive restrictions with no end in sight," Sean Hannity said an hour later. "With all due respect to Dr. Fauci's expertise, no one elected him to anything," Laura Ingraham said during her 10 p.m. show.
Overall, more Americans trust the information they receive from Fauci (67%) than from Trump (36%), according to a CNN Poll conducted by SSRS released this week. But they are divided along partisan lines. Republicans are more apt to say that they trust the information they get about coronavirus from Trump (84%) than they are to say they trust the information they get from Fauci (61%) or the CDC (72%). Among Democrats, just 4% say they trust the information they get from the President, well behind the 81% who say they trust Fauci or the 80% who trust the CDC.
Among Trump's aides, there has been some grumbling about Fauci and his cautious approach to the pandemic. As Trump has phased out his daily coronavirus briefings, public appearances by his health experts have also waned.
Fauci denied having a contentious relationship with Trump during his testimony on Tuesday, and White House officials affirm the men have an amiable working bond. Instead, the contention appears to lie in what advice Trump is willing to accept, and how candid Fauci is in public when assessing the outbreak
One official said some inside the White House are trying to reframe the debate away from "health versus economy" -- which has been the dynamic as states begin considering their reopening plans -- and toward "health versus health": trying to make the case that the nation will be better off in the long run by moving toward reopening from a public health standpoint.
White House press secretary Kayleigh McEnany appeared to be making that turn on Tuesday, citing new warnings of an uptick in drug and alcohol deaths, as well as suicides, during the outbreak.
"There are consequences to us staying closed," she said.