The Centers for Disease Control and Prevention suffers from a trust deficit and plummeting approval numbers two years into a COVID-19 crisis, after early missteps confronting the pandemic and guidance that has been late in coming or has been too confusing.
Even some of the agency’s biggest champions say it is trying to claw its way back after a wobbly start in fighting the virus and, most recently, trailing states in offering guidance on masks instead of leading the way.
“I characterized myself somewhat facetiously as president of the CDC fan club because I used to work there. That doesn’t mean I think my favorite agency has done everything exceedingly well,” said William Schaffner, an infectious disease specialist at Vanderbilt University who fulfilled his draft obligations at the CDC from 1966 to 1968. “I think the messaging has been often late and not clearly explained. Some of the public health messages have been too complicated. They violated the KISS [keep it simple, stupid] rule.”
Dr. Tom Frieden, who led the agency under President Obama, said a faulty COVID-19 test and rifts with the Trump White House knocked the agency off-kilter from the start of the pandemic. He said people are linking the agency to Mr. Biden’s political orbit, so the CDC should maintain distance by addressing the public on its own.
He is hopeful that new mask guidance, which separates counties into red, yellow or orange risk levels, can help the CDC regain some ground as the U.S. tries to manage COVID-19. As of Thursday, more than 9 in 10 Americans lived in a place where the CDC does not recommend universal masking.
“I think things got off to a bad footing in 2020 with the laboratory error and the federal government’s organization, or lack of organization, and it’s been difficult to play catch-up,” he said. “I do think the traffic light system last week is a good step forward.”
The CDC developed a polymerase chain reaction, or PCR, test to detect the coronavirus in January 2020, but it quickly ran into problems. Labs reported inconclusive results, prompting the agency by February to conclude the tests had been contaminated during manufacturing with synthetic fragments of the virus’ genetic sequence. An internal review later found inherent flaws in the technical design of the test.
The faulty tests made it difficult to track the virus early on and prompted experts to say the government should have tapped private labs and universities to develop the tests from the start.
Two years later, the CDC still has a big leap to regain some of the ground it has lost with the public.
A Pew Research Center poll released last month found Americans are split over the CDC’s performance but are increasingly taking a dim view of the agency.
Roughly half (49%) of Americans say “public health officials such as those at the CDC” are doing a fair or poor job, and half (50%) say those officials are doing an excellent or good job in handling the pandemic response.
The share of those giving officials a positive review is down 10 points from August and down nearly 30 points from the start of the pandemic in March 2020, when 79% had a positive outlook on the agency.
The CDC’s problems started early in the pandemic, during the Trump administration. Morale dipped as CDC officials were sidelined in favor of White House events and as newly installed health officials, including an obscure Canadian health researcher, were accused of meddling in the CDC’s closely watched “MMWR” research reports.
Problems continued into the Biden administration as it was perceived as too slow to adjust its guidance, offered advice that was confusing or too elaborate, and continued to share the stage with Dr. Anthony Fauci and White House officials when, in the past, they would be front-and-center or conduct their own press briefings.
A decision to relax mask guidance during the Biden administration last spring caught state leaders off-guard. It didn’t seem pegged to any specific threshold or benchmark in case counts but rather the belief that vaccinated people weren’t getting infected or spreading the virus. The guidance was reversed by midsummer, however, when the delta variant made it clear that vaccinated people could spread the virus. Scientists grumbled that the data underpinning the reversal wasn’t published until days after the announcement.
The CDC’s decision to shorten isolation guidance this year sparked worries that some people might still be infectious after they reenter society, and CDC data on the share of vaccinated and unvaccinated people who get infected, end up hospitalized or die is often incomplete or weeks old.
The CDC historically has had a solid reputation. Other countries even name their disease-fighting agencies the “Centers for Disease Control” in a kind of mimicry of the American system. The U.S. version is based in Atlanta, which is supposed to give it a de facto form of separation from Washington and its political sphere.
“I think the main thing that could have been done differently — I don’t know how much it would have changed all of this — is for the CDC to speak more frequently and more clearly, directly to the public from Atlanta,” said Dr. Frieden, the president and CEO of the Resolve to Save Lives, a global health initiative.
Dr. Frieden said recent polling suggests people are generally dissatisfied with federal and state officials guiding the pandemic response, not just the CDC, and pointed to the partisan split in the Pew poll.
“The decrease was almost entirely among Republicans. With almost no decrease among Democrats,” he said. “And what that tells me is partly it’s the message and partly it’s, you know, overidentification with the Biden administration.”
Indeed, Republicans were particularly critical in the Pew survey. Only 26% of Republicans and Republican-leaning voters said public health officials, such as those at the CDC, were doing an excellent or good job, compared with nearly 7 in 10 Democrats.
An NBC News poll from January found that only 44% of respondents trusted what the CDC said about COVID-19 and 43% did not. The rest had no opinion or weren’t sure. That compared with 57% who trusted their employers’ statements about the pandemic and 51% who said they trusted what their child’s school had to say.
Some Americans and congressional Republicans have been galled that recent guidance seemed to ease mask rules on adults before schoolchildren, whose age puts them at a relatively lower risk of severe disease from COVID-19. The CDC still recommends masking in schools within orange-coded, or high-risk, counties.
“Any sort of masking requirements shouldn’t be a condition of in-person learning. What will it take for the CDC to take children’s overall well-being and development into account for public health guidance? Doing so would go a long way in rebuilding trust and confidence in their work,” Rep. Cathy McMorris Rodgers of Washington, the senior Republican on the House Energy and Commerce Committee, said after the CDC updated its guidance on Feb. 25.
The CDC did not return requests for comment about its reputation, but Director Rochelle Walensky recently acknowledged that people were confused about shifts in guidance and her agency should have prepared people for shifts alongside the virus. She said shedding masks for the vaccinated made sense against the original strain last spring but should have added “for now,” because the delta wave scrambled assumptions.
“Given the curveballs of this pandemic, we perhaps need to sort of articulate a little broader: ‘But this could change.’ If there’s new and evolving science, new and evolving variants, new and involving scientific information, then we will follow it, and then we will make changes accordingly,” she told Insider, formerly known as Business Insider, in January.
Dr. Walensky and her top officials have started to brief reporters directly instead of solely alongside White House officials. The agency held its own call to announce the new mask guidance.
The guidance has been well-received by experts as a way to look at risk holistically as the country tries to manage it as another seasonal scourge instead of a constant crisis. Still, the guidance was released weeks after many Democratic-leaning states moved on their own to relax mask mandates even though policy typically flows from CDC guidance.
“Over the last two years, the agency has repeatedly been behind the curve in its data collection, analysis and recommendations. As we continue to reflect on the lessons learned from the pandemic, it’s critical that we improve the CDC’s accountability and transparency,” Sen. Richard Burr of North Carolina, the senior Republican on the Senate Health, Education, Labor and Pensions Committee, told The Washington Times.
Mr. Burr said legislation he proposed with committee Chairwoman Patty Murray, Washington Democrat, would “address these systemic and cultural failures at the agency to ensure the CDC is forward-looking amid an ever-changing public health landscape.”
The proposed PREVENT Pandemics Act would, among other efforts, require a Senate-confirmed CDC director and a strategic plan from the agency on improving detection and monitoring of emerging diseases.
It also seeks to improve data collection amid complaints that incomplete and outdated figures made it difficult for the public and health departments to get a full picture of the crisis.
Dr. Frieden said that overhauling the U.S. system will be difficult, given the balkanized nature of data reporting among 3,000 counties.
“You know how you go to a different country, they have a different kind of wall socket plug?” he said. “If you told all the 3,000 counties, 50 states, big cities: ‘You’ve all got to change your wall socket plug and all the wiring that goes into it, and I’m not going to give you any money to do and the new system may not work a lot better than your old system’ … that’s kind of what’s happening now, in terms of the data. So to change, it is going to take a lot of time.”
For more information, visit The Washington Times COVID-19 resource page.
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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