CDC Covid Guidance Must Adapt To New Science More Quickly

The Centers for Disease Control and Prevention should adapt its Covid recommendations more agilely when new science emerges, Dr. Scott Gottlieb told CNBC on Monday, adding that the agency should also do so with more transparency.

“These guidelines have more of an impact on the economy than regulation,” but they get much less public scrutiny, Gottlieb said in “Squawk Box.”

The former Food and Drug Administration commissioner’s comments came after the CDC on Friday changed its guidelines on social distancing in schools, not in society at large. The public health agency said that with universal masking most students can sit 3 feet apart, rather than the previous 6-foot protocol. The CDC also continued to recommend at least 6 feet of distance between adults in schools and between adults and students.

In an opinion piece in The Wall Street Journal on Sunday, Gottlieb urged the CDC to be more forthcoming about the science behind its guidelines, writing that the “exact basis for its initial vision of staying 6 feet away” remains without be clear. In the Journal and on CNBC, he said that initial recommendations and precautions early last year were based on the spread of the new coronavirus as seasonal flu.

“It was reasonable to do that because we didn’t know much about the coronavirus, so we assumed it would behave like the flu. It has not behaved like the flu,” Gottlieb said on “Squawk Box,” claiming he directed health officials. to “overestimate and underestimate this virus” in a crucial way.

“It’s not as important a question as, ‘Are we wrong about that?’ We were wrong in certain respects, “added Gottlieb, who led the FDA from 2017 to 2019 in the Trump administration. “But, ‘Did we learn fast enough and adapt our recommendations and guidelines fast enough?’ The answer is no.”

In a statement to CNBC, a CDC spokesperson said that during “the first year of the pandemic, there were concerns about some of the CDC’s guidance.” However, the spokesperson said that the agency’s new director under Joe Biden’s chairmanship, Dr. Rochelle Walensky, has “committed to restoring scientific credibility and public trust in the agency,” noting that he included review of the agency’s Covid guidelines to ensure they reflect the latest science.

We underestimate the role of air quality and high-quality masks because we underestimate that this is spread through the transmission of aerosols.

Dr. Scott Gottlieb

Former FDA Commissioner

Gottlieb told CNBC that health officials “overestimated the usefulness of physical distancing because the flu is predominantly spread through droplet transmission, and we know that droplets do not spread more than six feet.” On the other hand, he added, “we underestimate the role of air quality and high-quality masks because we underestimate that this is spread through the transmission of aerosols.”

Initially, there had been some skepticism from doctors about whether it would be effective to recommend that Americans cover their faces, particularly something homemade, such as a scarf or kerchief. However, in early April last year, the CDC began recommending that people wear them in public, especially in settings like grocery stores, where social distancing was more difficult to maintain.

Currently, there is little debate in the public health community about the importance of wearing face masks, and some experts, such as Dr. Anthony Fauci, the White House’s chief medical adviser, have even begun to warn that wearing two is likely. masks more effective.

In October, the CDC recognized that the spread of the coronavirus can occur through airborne particles, which can “stay in the air for minutes or hours” and end up infecting people who were more than six feet away from each other.

On the CDC’s webpage titled “How COVID-19 Spreads,” the public health agency says it “most commonly” does so through close contact between people within 6 feet.

“There is evidence that under certain conditions, people with COVID-19 appear to have infected others who were more than 6 feet away,” the CDC adds. “These transmissions occurred inside closed spaces that had inadequate ventilation. Sometimes the infected person breathed with difficulty, for example, while singing or exercising.”

Areas where Covid risks were initially overestimated also included contaminated surfaces, Gottlieb told CNBC. The CDC in May 2020, about two months after the World Health Organization declared the coronavirus a pandemic, updated its website to emphasize that the virus is not easily spread by a person touching a contaminated surface, according to NBC. News.

Gottlieb recognized that in the early stages of a health crisis like the Covid pandemic, there may be a lack of quality information to use as a basis for guidance.

“When the CDC issues recommendations, there are different levels of evidence behind those recommendations and different levels of certainty,” he said. “When the agency is unsure, or is preaching a less safe science recommendation, they really should be transparent about it so that we can make a serious interpretation that we want to take it, but they usually don’t do that.”

The CDC spokesperson told CNBC that following the agency’s recent review, “key learnings” have already been implemented, including “reviewing the main guide for possible updates at least every three months,” as well as “improving clarity and usability. “

Dr. Scott gottlieb is a contributor to CNBC and a member of the boards of directors of Pfizer, genetic testing startup Tempus, healthcare technology company Aetion, and biotech company Illumina. He also serves as co-chair of Norwegian Cruise Line Participations‘ Y Royal Caribbean“Healthy candle panel”.


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