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Dismay That CDC Is Not Front And Center In The Fight Against The
Pandemic Is Growing More Intense
Sidelining The
Agency Said To Be Costing Lives
At first, concerns
about the absence of the CDC Director and other agency leaders at
White House public briefings about the COVID-19 pandemic were shared
quietly “within the family” between epidemiologists and other public
health professionals. Then, in mid-April, former CDC Director Tom
Frieden published an op-ed in the New York Times, stating “Just
when American most needs its guidance on the pandemic, the country’s
top public health experts do not appear to be guiding, and are
certainly not communicating our response.”
Premier Public
Health Agency
Also, Ashish Jha,
director of the Harvard Global Health Institute, writing this month in
STAT News said “during this pandemic when timely, nationwide
information is the lifeblood of our response, the CDC has largely
disappeared.” He called CDC “the premier public health agency in the
world”, and asserted “Americans are suffering and dying because CDC’s
voice is absent.”
Depolitization
Rich Besser,
former acting director CDC and now at the Robert Wood Johnson
Foundation said it a recent video chat that Americans are not hearing
from CDC about best practices in this pandemic. He called for
depoliticizing the information provided to the public and agreed that
it was “detrimental” to American public health not to be receiving
these regular briefings.
Press Briefings
The last CDC press
briefing on the pandemic was on March 19 and efforts to restart them
have been rebuffed by the White House, according to media reports. Two
former CDC employees, Bruce Weniger and Chin-Yih Ou
published an essay on Medium saying the lack of CDC direct
communication is “denying a worried public straight talk from what has
been the world’s premier public-health agency.”
Lancet Editorial
Also, a recent
editorial in the Lancet titled “Reviving The US CDC” states
the Trump administration's further
erosion of the CDC will harm global cooperation in science and public
health, as it is trying to do by defunding WHO. A strong CDC is needed
to respond to public health threats, both domestic and international,
and to help prevent the next inevitable pandemic.
Why Low Profile
One possible
explanation for CDC’s absence was the ubiquitous media presence of the
NIH’s Anthony Fauci
whose knowledge and experience with
infectious diseases are widely respected. With a non-partisan
reputation and a clear focus on the science, having Fauci in a
prominent role communicating with the public was reassuring to many
laypersons as well as scientists.
Yet Fauci’s knowledge
and experience has come from leading a research institution, and NIH
does not have CDC’s relationships with state and local health
departments, a tradition of holding regular briefings during evolving
outbreaks, and a large cadre of disease detectives with a respected
reputation for responding effectively to outbreaks in all parts of the
world.
Points of Tension
However, as time goes
on, it becomes clearer that there are multiple points of tension
between CDC and the White which might better explain CDC being
prevented from playing its rightful role in fighting the pandemic.
Some of these reasons
have been described in multiple media accounts, including the
following:
1. It seems clear that
the leadership in Washington is not interested in developing a
coordinated national plan for addressing the different pandemic
challenges. This is so despite multiple pleas to do so from leading
epidemiologists such as Minnesota’s Michael Osterholm and
others. Putting CDC in charge would signify a federal level commitment
and obligation.
2. The White House is
questioning the validity of the death counts being reported by the
Mortality Statistics Branch in CDC’s
National Center
for Health Statistics. Claims are being made that deaths are being
overcounted when expert opinion is that the US is actually
underestimating the deaths from COVID-19.
In an
interview with the Daily Beast, the chief of that activity at CDC said
“The system can always get better. But if we’ve learned anything it’s
that we’re seeing some of these individuals who have died of the virus
slip through the cracks…It’s not that we’re overcounting.”
3.
Another tension is the limited guidance on reopening different sectors
of American society which has been published by the CDC. After early
versions of the guidance with specific recommendations were leaked to
the press, a revised and much less specific version was published on
the CDC website, according to the Washington Post. Now a more detailed
guidance document is available, but this document, is nothing like
what we are accustomed to seeing from CDC, according to Weniger .
Interviewed on the Rachel Maddow show, he said the new guidance
is complicated, inconsistent, and full exceptions to exceptions. In
his opinion, CDC personnel must be embarrassed to see it.
4. Criticisms of Robert Redfield, the CDC
Director, are also beginning to surface such as those in the
Washington Post recently. Redfield is accused of being an ineffective
communicator and a weak leader not in control of his agency and not
on a par with others in the struggles within the White House
environment.
5. There is an ideological struggle
according to the former CDC employees between those who believe
government has a constitutional role to play in promoting the general
welfare and those who place more faith on the private sector. In this
category appears to be the recent award of a contract to a Pittsburgh
company to collect data from hospitals which is already being reported
to the CDC Healthcare Reporting Network.
Richard Jackson,
professor emeritus at UCLA and a former CDC Center Director told the
Post, “it is unprecedented that you’d set up a competing system
separate from CDC."
Painful moment
According to Jha,
“this must be a painful time for the many extraordinary career
scientists who continue to work at the agency. But it's a painful
moment for the American people too and with deadly consequences. Real
CDC leadership—clear, science based guidance, effective coordination
of states, and public transparency of data---is absolutely essential
for confronting and getting clear of this crisis.” He concludes, “The
CDC was once the world’s greatest public health agency. We need that
CDC back, and we need it now.”
Scientists Under
Duress
An indication of just
how painful a time it is for many at CDC, NIH, and other agencies is
the recent decision to terminate an NIH grant to the ECO-Health
Alliance, a private research organization doing work on coronaviruses.
According to our sources at NIH, these researchers are doing the best
research on coronaviruses. Yet because of
misinformation about the relationship with the research facility in
Wuhan and because of unproven theories about the true origins of the
virus, the NIH grant was terminated without due process.
The
grant cancellation was recently the subject of a special expose report
on 60 Minutes. When the best researchers in the world have their work
cancelled for political rather than scientific reasons, then you can
understand the difficult environment that our government scientists
are working in, said the NIH source.
In a
recent op-ed in the NY Times, Seema Yasmin, a former CDC
Epidemic Intelligence Service (EIS) Officer concluded by saying, "Given
the complex relationship between American public health law,
regulations and epidemiology, a complete divorce of politics from
public health might not be feasible anytime soon. But week after week,
as Covid-19 has killed almost as many Americans a day as the Sept. 11
attacks, our best response against the pandemic demands unleashing the
top disease detectives in the world and fully applying their advice.
E.I.S. officers were trained to fight this battle, and no one should
stand in their way.”
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