CDC needs serious scrutiny to restore Americans’ trust in science
Just when it looked like the Centers for Disease Control and Prevention’s (CDC) COVID management and messaging was going to get some long-overdue oversight, President Biden made a move to protect this gargantuan example of failed bureaucracy with a proposed $22 billion in new spending for the agency, doubling its budget.
Polling last summer showed that many Americans have lost faith in the CDC. Only 32 percent of respondents in an August Gallup poll said they believed the CDC was communicating a clear path to prevent COVID infection. Pew data from January showed 60 percent of respondents found CDC recommendations confusing.
While the CDC was losing credibility, the Government Accountability Office (GAO), Congress’s watchdog, was quietly investigating the agency’s handling of the COVID crisis. On Jan. 27, the GAO delivered a rare “high risk” rating to the Department of Health and Human Services, specifically citing the CDC’s poor data management and ineffective messaging. These findings added fuel to congressional proposals to set up an independent COVID commission to examine the CDC’s performance.
The CDC’s antiquated information system, designed in 1925, could not support modeling to show how a pandemic might spread, or a real-time picture of how the COVID crisis was developing. This information would have been useful to developing an effective containment strategy. Yet, the CDC’s estimates were always days old.
By itself, this merits bad marks. We now know, however, from reporting by The New York Times, that the CDC was purposefully hiding information all the while on infection rates, hospitalizations and deaths attributable to COVID, likely making the crisis appear even more severe. And a recent study by economists at Johns Hopkins found that masking and social distancing — central in the administration’s approach to containing the spread of COVID — were completely ineffective.
Ironically, while the CDC has yet to acknowledge that much of its advice was misleading, not grounded in science, or simply wrong, the U.S. surgeon general, who heads the U.S. Public Health Service’s uniformed corps, just announced his intention to force social media companies to disgorge sources of “misinformation” that appear on their platforms.
The CDC is in dire need of top-to-bottom reform. Consider the damage it did to the public’s trust in science with its mantra of (in effect) “We follow the science and it is always changing.” This rhetorical cover for political science — not virology — rightly could cause citizens to doubt expert guidance in the future.
The problem may be that the agency no longer appears to believe in its own special brand of science. The modern era’s public health knowledge base began in 1854, when a London physician stopped a cholera epidemic by mapping infected people and concluding that water in a specific well was causal. This began a long process of learning by trial and error, leading to a universally agreed-upon set of steps to control communicable diseases: case-finding, contact-tracing and quarantine. But in attempting to contain COVID, contemporary public health officials pursued these steps with a half-heartedness that would have scandalized previous generations of epidemiologists. Instead, they hung their hopes on a new vaccine.
The failure of the CDC to manage COVID-19 more effectively points to an endemic problem of bureaucracy — namely, seeking to appear more relevant as a means to grow bigger. Over the last three decades, the CDC has de-emphasized its principal mission of protecting Americans from novel microbes and viruses that, if uncontrolled, can kill millions. Instead of modernizing its information systems, to choose but one example, the agency has sought a role in solving more high-profile social problems. Shamefully, it has encouraged a promiscuous use of the term “epidemic” to describe conditions that its methodologies are powerless to affect, including racism, gun violence, child abuse, sex trafficking, opioid abuse, obesity and loneliness. The CDC won’t be the agency that ends those crises, and trying to do so only distracts from its critical core mission.
The enormous infusion of funds headed to the CDC is part of the president’s newly unveiled COVID National Preparedness Plan, a document that seems a little late in coming. With its publication, the White House spares the CDC critical examination of its performance. Rewarding failure, however, will surely result in an even less effective response to the next pandemic.
Carl Schramm is a professor at Syracuse University and is a senior adviser to the COVID Commission Planning Group. His most recent book is “Burn The Business Plan” (Simon and Schuster, 2018).