Can We Trust the CDC Anymore?
Former senior U.S. health officials, infectious-disease experts and pundits alike are expressing lost faith and trust in the leadership of the U.S. Centers for Disease Control and Prevention given the agency’s blatant politicization and sidelining of science in favor of announcements and guidelines dictated or vetted by the White House. A widely shared Aug. 31 New York Times opinion piece, co-written by former director of the National Institutes of Health Harold Varmus, is headlined “Ignore the CDC.”
Is it really that bad?
“Recent actions by the CDC have led many in public health to call into question the integrity of the CDC’s leadership as they ignore the science and bow to political pressure,” writes Catherine Troisi, PhD, an associate professor of management, policy and community health at the University of Texas Health Science Center. “Their actions have hurt public health efforts and led to confusion and mistrust by the public at large.”
Troisi’s criticism is moderate compared to some.
“We have an epidemic of anti-science coming from U.S. government agencies,” says Eric Topol, MD, a professor of molecular medicine at the Scripps Research Institute in California, calling out both the CDC and the FDA.
The FDA has had its own leadership stumbles of late. Director Stephen Hahn supported a White House announcement of a “breakthrough” in Covid-19 treatment using convalescent plasma, which Han later walked back after scientific outcry over the treatment’s unproven efficacy. Then Hahn suggested the FDA might fast-track a coronavirus vaccine before properly testing it for safety. He later said any vaccine approval will be made “on the basis of science and data” and not “on the basis of politics.”
Topol has called for Hahn’s resignation.
Once a leader
The CDC’s historic role has been to lead the nation through everything from a regular flu season to pandemics, with regular written and data-filled updates and routine public appearances when things look bad. The agency took the initial leadership role in communicating about the coronavirus directly to the American public in January.
By many accounts, the CDC credibility crisis has been created by the White House in concert with, or without resistance from, CDC Director Robert Redfield. Whether on purpose or for fear of losing his job, Redfield has allowed the agency to become politicized, with the White House dictating what it’s allowed to say and how to say it, critics charge.
The politicization of the CDC began in the early weeks of the pandemic, when the White House silenced the agency repeatedly. A few weeks back, the CDC changed many of its back-to-school guidelines to “suggestions,” again seen by experts as going against good science. The crisis reached a crescendo recently when the agency flummoxed health experts by adjusting its guidelines to reduce Covid-19 testing of people who worry they may have contracted the disease but don’t have symptoms. (Studies suggest a majority of coronavirus infections arise from people who don’t have symptoms.)
“Many of us are confused by @CDCgov excluding people without symptoms from testing guidelines,” tweeted Natalie Dean, PhD, who studies emerging infectious diseases at University of Florida and, like other such experts, says more testing, not less, is needed to help get the pandemic under control.
“It’s an enormous scandal,” Carl Bergstrom, a biologist at the University of Washington, tells NBC News reporter Denise Chow, referring to recent developments at the CDC and the FDA. “What it looks like at this point is you have a White House altering public health advice to improve election chances to the detriment of American lives.”
Bergstrom later tweeted: “Tens of thousands of unnecessary deaths and the ruination of what was once perhaps the world’s great public health institution. This is your legacy, @CDCDirector Redfield.”
On our own?
The trust issue is not with CDC scientists. If the CDC is allowed to resume its previous non-political, science-based leadership role amid a health crisis, under new leadership, it’s reasonable to assume it can again be viewed as trustworthy in the broader scientific community. But trust can be a difficult thing to regain once you’ve lost it — especially, in this case, when it’s scientists and other experts, as well as the public, who are losing their faith in you.
“Trust is an essential part of any epidemic response,” says Tom Frieden, former director of the CDC. “What we’ve seen in recent days from the CDC has threatened to undermine public confidence in the agency. That’s unprecedented and dangerous.”
Meantime, should we outright ignore CDC?
At best, one must certainly read between the lines of its statements and try to suss out the science from the politics. Unfortunately in the meantime, state and local health officials, who have been making many of their own disparate decisions amid a lack of federal leadership throughout the pandemic, are on their own more than ever to set safe health policies and guidelines.
“It does not bode well if we Americans can no longer trust the advice and guidelines emanating from our national public health entity,” Troisi writes, “not just for control efforts in this pandemic but for future health concerns as well.”