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CDC back under scrutiny after new mask guidance

CDC back under scrutiny after new mask guidance

When President BidenJoe BidenBiden prepares to confront Putin Ukrainian president thanks G-7 nations for statement of support Biden aims to bolster troubled Turkey ties in first Erdoğan meeting MORE took office, he vowed to empower the scientists and medical officials at the Centers for Disease Control and Prevention (CDC) after the revered agency saw its morale and credibility sink under former President TrumpDonald TrumpBiden prepares to confront Putin Biden aims to bolster troubled Turkey ties in first Erdoğan meeting Senate investigation of insurrection falls short MORE.

The CDC has made significant strides to restore its reputation in the first few months of the Biden administration, according to experts who work closely with it, but the agency has had a rocky few weeks that has put a spotlight on its leadership and its relationship with the White House.

The most notable stumble came last week when the White House was caught flat-footed by a major update in CDC guidance that said vaccinated people do not need to wear masks indoors or outdoors, according to multiple people familiar with the process.

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Biden was informed the night before about the forthcoming announcement, which came just two weeks after the agency said vaccinated individuals didn’t need to wear a mask outdoors.

The outdoor mask guidance was widely criticized as being confusing and contradictory.

Biden officials, who have spent months urging Americans to mask up while cautioning the fight against the pandemic was far from over, were suddenly shifting to explain how the guidance had so quickly changed and why it was now OK for many Americans to go maskless in almost all settings.

“I think Rochelle WalenskyRochelle WalenskyStudy: Older Americans saw larger declines in COVID-19 cases, hospitalizations and deaths after vaccine became available Overnight Health Care: Biden 'very confident' in Fauci amid conservative attacks | House Dems press Biden on global vaccinations | CDC director urges parents to vaccinate adolescents New York plans to loosen school mask rules as soon as Monday MORE and the CDC, with strong White House support, has regained a lot of their lost trust and reputation,” said Lawrence Gostin, a Georgetown University professor who has worked with the agency for decades, referring to the CDC director. “But I think this will be a significant erosion of that trust and confidence in the public. Because it looks like the CDC literally did an about face that it lurched from overcaution to abandoning all caution.”

Officials at multiple agencies privately questioned whether politics played a role in the rapid change in masking guidance, noting the science behind vaccine efficacy had not changed in the two weeks since the CDC had first eased recommendations. One official noted it was unusual for the president to be reacting and changing his message to cater to the CDC rather than leading the way or being in concert with the health agency.

White House officials have denied that politics played any role, and downplayed the notion that there was any friction with the CDC over the timing of the most recent mask announcement.

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One official argued that science is constantly changing when fighting a once-in-a-generation pandemic, so the timing of any guidance will rarely be clear cut.

Glen Nowak, who worked in media relations at the CDC under Democratic and Republican administrations, said the agency needs some independence from the White House, but there also needs to be collaboration. 

The problems arise "when you assume that independence means that you hold things close to the vest, and you're reluctant to share them internally with other parts of the federal government, including [the Department of Health and Human Services] and the White House. Then people are going to be surprised ... and that puts them in a really difficult spot," said Nowak, who now teaches at the University of Georgia.

On a call with governors Tuesday, some state leaders questioned the rollout of the new guidance, expressing concerns it could lead to a kind of free for all.

Prior to the CDC's guidance shift, the White House had been urging states not to roll back their mask mandates.

But after last week’s announcement, states and cities were scrambling to figure out whether to change their rules to match the new federal advice.

Governors of more than a dozen states across the political spectrum said they would drop their mask mandates as a result.

Biden, dating back to his time on the campaign trial, made clear he would seek to wall off the CDC and health agencies from political pressure, setting up a clear contrast to his predecessor.

Trump spent much of the pandemic routinely undercutting and berating officials at the CDC, the National Institutes of Health and the Department of Health and Human Services. Trump even called former CDC Director Robert RedfieldRobert RedfieldEx-CDC director Redfield says he received death threats from fellow scientists over COVID-19 theory Fauci may have unwittingly made himself a key witness for Trump in 'China Flu' hate-speech case CDC back under scrutiny after new mask guidance MORE in September to criticize him for his testimony to lawmakers in which he said mask use could be of greater importance than a vaccine to guard against COVID-19.

Julie Morita, executive vice president of the Robert Wood Johnson Foundation, who advised the Biden transition team on COVID-19 issues, said she wishes the CDC had rolled out the mask guidance in a more coordinated fashion so that everyone from the White House to local health departments would have been better able to respond.

Still, she said the fact that the White House was caught off guard speaks to the trust administration officials have with the CDC.

"They have the freedom to be able to make recommendations, and to make big changes without having to vet everything and get everything approved. If the White House didn't trust CDC, they wouldn't give Dr. Walensky the freedom to make these kinds of announcements," Morita said.

The Biden administration has made a concerted effort to emphasize the CDC’s independence, allowing its director and other officials to hold regular briefings separate from White House officials and repeatedly noting the West Wing does not intervene when the agency is developing guidance around the pandemic.

Biden only interacts with Walensky occasionally, an administration official said. He more frequently discusses the state of the pandemic with his COVID-19 response coordinator, Jeff ZientsJeff ZientsBiden meets with UK's Johnson ahead of G-7 Overnight Health Care: White House unveils plan to donate 25M vaccine doses abroad | US COVID-19 cases, deaths fall to lowest levels since March 2020 | Poll: Majority support Medicare negotiations for drug prices White House unveils plan to donate 25 million vaccine doses abroad MORE.

"I don't think [CDC] is kind of an ivory tower where policies are made in isolation," said Tom Frieden, CDC director during the Obama administration, adding that it is often appropriate for the White House to review and comment on certain policies, but "you don't want the science to be in any way interfered with."

Frieden said he was "puzzled" by the reports that the White House was caught so off guard by the mask guidance. When White House chief of staff Ron KlainRon KlainBiden's no-drama White House chief The Democrats' proposed budget is a political and substantive disaster Senate GOP warns of 'vast differences' with White House on infrastructure MORE was in charge of the nation's Ebola response years earlier, Frieden said, "he was involved in reviewing policies and commenting on them, but he was always crystal clear that the decision on whether or not to take those comments, if they were on a technical issue, was entirely up to the CDC."

The agency is also dealing with some internal shakeups. Two top officials are set to depart within weeks of each other, which is likely to result in giving the director more control.

Nancy Messonnier, the CDC’s top respiratory diseases scientist who in early 2020 delivered a stark warning about the seriousness of COVID-19, announced last month that she would resign May 14.

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Messonnier had reportedly been reassigned recently from leading the agency's COVID-19 vaccine task force.

Anne Schuchat, the principal deputy director of the agency, announced she would depart this summer. Schuchat has served at CDC for 33 years.

One source close to Schuchat said she wasn’t initially planning to leave this year, but that her exit was hastened by political considerations at the agency and Walensky’s “mercurial” leadership.