|
Former CDC Director Bill Foege
Shares Perspective On COVID-19 “Looking Back From 2022”
Bill Foege,
former CDC Director and Emeritus Professor of International Health at
Emory, spoke at a Department of Medicine Grand Rounds in mid-January
with a presentation entitled “COVID-19—Looking Back from 2022”. A main
theme of his talk was to share lessons learned from smallpox
eradication and other outbreak experiences and how they were applied
or not applied in the coronavirus pandemic in the US.
Importance of
Management
Foege kicked off this part of his
talk by noting that smallpox did not disappear on its own and
reminding us that we live in a cause and effect world. He shared a
quote he remembered from long ago that “you should not confuse destiny
with bad management.” According to Foege, COVID-19 did not get this
bad by chance; it is because all of the lessons from the past were not
heeded.
First Lesson
First among those lessons is to know the truth about
what is happening. This is accomplished through surveillance which
normally has been led by the CDC. Instead, during this pandemic, this
surveillance function was done by journalists and Johns Hopkins
University, said Foege. He highlighted that President Trump was the
single greatest source of misinformation about the virus.
Need a Plan
A
second lesson is the importance of having a national plan. This did
not occur in the US and instead we had 50
states each trying to
do their own thing. Looking back from the perspective of 2022, Foege
said he was confident that the development of a national plan by the
Biden administration in January 2021 will be seen as a critical
determinant of our coming success over the next several months in
controlling the pandemic.
A third lesson that was violated is about the
importance of creating coalitions. Instead, the Trump administration
created competition between the 50 states for resources and materials.
The fourth lesson Foege shared is that the best
decisions are based on the best science and the best results are based
on the best management. The former was the case in the development of
the new vaccines but not the case in the deployment of the vaccination
program.
Culture
Another important lesson highlighted was the importance
of respecting the culture. He noted that the best approach to reaching
African Americans and other vulnerable populations is by “not being
the government that tells them what to do.” Instead he argued for
using trusted sources in minority populations such as black church
leaders, and black and Latino doctors to deliver good information.
WHO Decision
Foege showed his dismay at the decision of the US to
leave the World Health Organization. He said every decision should be
“based on a hope for global equity”, and given this principle, he
could not understand how anyone would leave WHO. He urged the US to
use the CDC to realign and repair the relationship with WHO because
CDC has a long history of working with the organization and many CDC
personnel have actually worked at WHO.
Not Blameless
While Foege noted that the Trump administration
violated every lesson learned from working on past outbreaks, he said
the public health as a field was not blameless. He asserted that the
public health community remained too quiet while these violations were
taking place and should have pushed back more. He admitted he should
have spoken out more effectively in early 2020. Asked during the
question period what he would have done had he been CDC Director
during the Trump administration, Foege said he does not know because
he never faced what the CDC Director faced in 2020. He did allow that
he probably would not have lasted long in his position..
Politics and Public
Health
In closing, Foege shared his belief that the challenge
going forward is for public health and politicians to work together as
a coalition to create the mechanisms so that public health will be
more resilient in the future. He proposed inviting the two new
senators from Georgia to a meeting at Emory as a first step to help
strengthen the connection that needs to be there between public health
and politicians. Contrary to those who would argue that public health
and politicians should not be mixed, Foege said he comes to the
opposite conclusion because public health needs politicians to provide
resources. That is, not corrupt politicians but rather those with a
moral compass.
To listen to the grand rounds session in its entirety,
visit:
https://bit.ly/3aW4fsi
■
|