The CDC director is seen as allowing the agency to buckle for political influence


I amn His first address to the staff of the Centers for Disease Control and Prevention, Robert Redfield called the Atlanta-based agency “the best science-based, data-driven agency in the world.”

As director of the CDC in March 2018, Redfield – whose name was his voice to break up repeatedly without success in tears – said that thousands of employees had dreamed of heading the prestigious institution, which was called for public health agencies The world was considered the gold standard. He gave them a serious voice.

“I pledge that I will work to continue this legacy,” said Redfield, a virologist and physician specializing in caring for people living with HIV. “We are not an opinion organization. We are a science-based, data-driven organization. This is why CDC has worldwide credibility.

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Now, 2 1/2 years into his tenure, the storied agency finds itself in new and treacherous waters, staining its reputation, and a historic low, current and former CDC insiders told STAT. Many say that Redfield is not enough to protect the CDC’s reputation and the integrity of its work, and that it is successfully failing to thwart political intervention that is eroding Americans’ trust in the organization.

“I find that the CDC director has not found examples of explicit political interference in the interpretation of science,” said Richard Beser, former acting CDC director and now president of the Robert Wood Johnson Foundation.

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Former CDC employees, many of whom have exchanged emails worrying about the agency’s situation, are deeply concerned but wary of speaking out. A former official said that the current staff has a question about what to do. The former officer said, “Even if you got more than a dozen resignations at the same time, this is a story of one day.”

Others were ready to speak publicly.

“I think [Redfield]Not showing the kind of leadership that I would expect to see in defending the institution and protecting science, ”said Mark Rosenberg, who was the first director of the CDC’s National Center for Injury Prevention and Control.

“A reputation that takes 75 years to build can be destroyed in four months. This is terrible, ”said Rosenberg, who is now retired but in contact with former colleagues.

Public health experts at the CDC who have led the nation’s responses to countless threats over the decades – the deadly emergence of HIV, the 2001 anthrax attacks, the SARS, the H1N1 flu pandemic, and Ebola bypassing and silencing the administration has given. In the midst of President Trump’s election campaign.

On several occasions, guidance documents written by CDC staff – recommendations that lead to the most up-to-date distillation of emerging science on the SARS-CoV-2 virus – have been revised by political appointees in Washington to reflect the administration’s goals. .

The guidance in helping churches to safely resume in-person services was originally recommended in May to support choirs in Washington State with many super-spreading events, including one Use has been suspended or at least reduced due to evidence. However, according to the Washington Post, that advice was dropped, citing the objections of Vice President Mike Pence’s office.

Former CDC director Tom Frieden – Redfield’s immediate predecessor – called the amendment “inappropriate”. It is putting people’s lives in danger. ”

Over the summer, according to several reports, officials in Washington intervened to change guidance about whether or not to reopen schools. To suggest that the CDC felt that schools were given paramount importance, it was changed to guide, even if doing so would have spread the Kovid-19.

“He worked on the school’s guidelines for months,” Rosenberg said of the CDC staff. “Around 24/7, they were working to get the best scientific guidance for the country. And then … the White House made an introduction to it on the CDC website, stating: ‘The most important thing is for children to go to school.’ It was not written by the CDC. There was nothing that the CDC people wanted to say. ”

Recently, testing guidance for Kovid-19 was changed to recommend against testing people who were exposed to cases, but asymptomatic. In fact, finding people as soon as possible to ask them to isolate them is the key to the spread of the virus. “It’s a misunderstanding of public health,” Frieden said.

The trial advice change prompted public health officials around the country to “not pay attention to the CDC” for the extraordinary publication of the op-ed in the New York Times late last month. It was written by Harold Varmus, former director of the National Institutes of Health and Rajiv Shah, president of the Rockefel Foundation.

In recent times, Politico and then other news organizations have reported that authorities in Washington have attempted to modify or delay the publication of scientific reports in the CDC’s online magazine Morbidity and Mortality Weekly Report. MMWR, as is better known, is the basis of public health. This is where the first report of AIDS cases in the United States was published; This is where public health workers demand the latest on an outbreak or a disease.

Michael Caputo, Department of Health and Human Services and his scientific advisor, Paul Alexander, a sometimes part-time university lecturer at McMaster University in Canada, was director of communications, reportedly seeking to read and replace MMWR articles before being published Were staying. Caputo has denied reading MMWR articles prior to publication.

The CDC refused to make Redfield available for an interview, but invited written questions for this story.

In a written response, the CDC director brushed aside all of STAT’s questions – about the political impact on the guidance documents, the revision of MMWR articles and his own pledge to preserve the agency’s reputation. Instead, he said he believes the CDC “remains the world’s premier public health agency.”

“I believe, without question, that CDC science, data, and service have had a tremendous impact on saving human lives”, Redfield wrote.

Redfield, a deeply religious man – he often ends an interview by saying “God’s blessing” – is described by many as earnest and kind. Caputo called the director “one of my closest friends in Washington” in a statement to the New York Times.

But sources indicate that Redfield is not a good listener. This is the deficiency of which he is aware; In his March 2018 address to the CDC staff, he said that his wife, Joey, had given him a to-do list for his new job: “The first thing was ‘listen.’ The second was, ‘Do not interrupt.’ The third was ‘listen.’ ‘

Redfield did not attend CDC with a public health background. And he struggled as a communicator, eroding his ability to advocate for CDC positions, suggesting several sources. At White House Coronovirus Task Force meetings, he is often asked for the more vocal Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Although he has stepped into the breech left by the CDC director, Fauci is also not a trained public health expert. Like Redfield, he is a virologist and an HIV physician.

Besar admitted that he has no idea how tough Redfield is for the CDC behind closed doors; Freeden noted that it has been reported that the CDC director pushed back on the MMWR issue.

But the Redfield agency’s lack of public defense he was so eager to lead is profound about CDC staff and alumni.

“The CDC director – and the same goes for anyone in leadership – will have to look inside themselves and say: ‘There is a line I will not cross. And there is a line that I will not allow others to cross, If it underscores the value of the agency, “Besar said.” And time and time again in this epidemic we have seen political actions undermining the credibility of the CDC, undermining public confidence in the CDC. .And we are not seeing a tremendous defense of that by the director of the CDC.

“What we’re seeing now is the erosion of that trust,” he said. “It is harmful and will lead to life.”