Former directors of the U.S. Centers for Disease Control and Prevention, the world-renowned American agency that has long taken the lead in fighting communicable diseases, are voicing unusual criticism of the U.S. handling of the novel coronavirus pandemic and the CDC’s limited role in that effort.
COVID-19, the disease caused by the virus, has killed more than 180,000 people in the U.S., and those are only the confirmed cases. The CDC says the actual number of COVID-19 deaths is much higher and that the virus will be a leading cause of deaths in the U.S. in 2020.
Five former CDC directors, appointed by both Republican and Democratic administrations, say the agency should be doing more to lead the effort to contain the pandemic.
Among them is Dr. Richard Besser, who as acting director of the CDC held daily televised news conferences during the H1N1 flu pandemic of 2008-09, which infected more than 60 million people in the U.S. and killed 12,469 people. Globally, the World Health Organization estimated that a half-million people died.
During the current pandemic, however, the White House Coronavirus Task Force is being led not by the CDC, but by Vice President Mike Pence, prompting questions about the extent to which the task force's advice may be seen as politically motivated.
“It really concerns me that we're not hearing from CDC every day. We're not hearing from them about what they consider to be the best practices in terms of isolation and quarantine, what needs to be done,” Besser said in a recent interview with STAT, a health publication run by the publishers of the Boston Globe newspaper.
“We're seeing so much that's being presented to us by political leaders, and when that's the case, half the country says, ‘Great, I'm on board,’ and the rest rejects things out of hand because of the messenger. ... The more you can depoliticize the response, the more successful you're going to be.”
That concern is shared by Dr. David Satcher, who was appointed to lead the CDC by Democratic President Bill Clinton. “I think it was obvious during the time that we were having daily reports about the pandemic that CDC was being sidelined,” Satcher said in an interview, regarding the task force’s late afternoon briefings earlier this year.
He contrasted that with the prestigious role the agency held when he was director. "What I remember is that whenever there was a major issue in the world, people called the CDC before they called the World Health Organization, even though there was a very good working relationship between the CDC and WHO."
The former directors acknowledge shortcomings in the performance of the agency itself, which in the early days of the pandemic rolled out a defective test and advised the public against wearing face masks – advice that was later reversed when the extent of asymptomatic transmission became understood.
But medical professionals have learned a lot about the coronavirus since then, according to Dr. Julie Gerberding, who became director of the CDC under Republican President George W. Bush. She is now an executive vice president at the pharmaceutical giant Merck.
Gerberding recently told ABC News that she would love to turn back the clock because so much has been learned about the virus since it first appeared. "We know it is incredibly transmissible," she said, "and we know that most people are still susceptible."
When Dr. Tom Frieden headed the CDC, after his appointment by President Barack Obama, a Democrat, the CDC was highly involved in the Ebola crisis in West Africa, from 2014 to 2016. Frieden now heads a global public health initiative called Resolve to Save Lives.
He has been among the most outspoken of the former directors in accusing the Trump administration of dictating health policy to the CDC.
“I don't think there's ever been a time before when people from the White House or HHS are dictating what goes on technical documents on the CDC website,” he said Thursday during a webinar sponsored by Vital Strategies, a global health organization. “This is dangerous. This is a big problem. It's a big problem for a lot of reasons, as some of you know the CDC.”
Satcher and the others are critical of President Donald Trump's push to open schools and businesses when, they say, the virus is not yet under control. They say rushing to get things back to normal will only spread the virus.
A number of universities have had to close after the virus spread when students returned to campus for the fall semester. A judge in Florida ruled that public schools don't have to abide by the state's requirement for in-person instruction because it “arbitrarily disregards safety” and denies local school boards the ability to decide when students can safely return.
Besser, now president of the Robert Wood Johnson Foundation, the largest health philanthropy in the U.S., says CDC guidance needs to be followed for the public good and that it should not be seen as "a barrier to getting children back into school instead of a road map for doing it safely."
Satcher, who founded the Satcher Health Leadership Institute at Morehouse School of Medicine, told VOA that "the priority in any pandemic ought to be prevention." He also said fighting a pandemic requires leadership from the president.
The former directors have been critical of what they called misleading information coming from the White House. Trump has touted the malaria drug hydroxychloroquine, which the health specialists say does not cure COVID-19 and may be harmful.
Although Trump later said he was being sarcastic, a remark he made about injecting disinfectants as a means to treat the virus prompted companies that produce them to run televised advisories warning people that their products could be deadly if injected or ingested.
Dr. Jeffrey Koplan spent 26 years at the CDC. He was the director from 1998 to 2002, and later established the Atlanta-based Emory Global Health Institute.
"We need to feed truth back to the American public and to use those truths with our scientific evidence to control this disease," he said.
All agree that pulling together and following the science is the best course. They also recommend following standard disease prevention methods like avoiding crowds, practicing good hand hygiene, staying at least two meters from others, and wearing masks when in public.
Trump has been seen wearing a mask in public only twice. An audience at the White House Rose Garden did not wear masks during first lady Melania Trump's speech during the Republican National Convention.
When VOA asked for a response from the White House, Deputy Press Secretary Judd Deere told VOA, “The White House and CDC have been working together in partnership since the very beginning of this pandemic to carry out the president’s highest priority: the health and safety of the American public.
"The CDC is the nation’s trusted health protection agency and its infectious disease and public health experts have helped deliver critical solutions throughout this pandemic to save lives," Deere said. "We encourage all Americans to continue to follow the CDC’s guidelines as we responsibly continue to open up America."
The CDC has reversed its recommendations on testing for COVID-19. The agency had been recommending that those who have been exposed to the virus get tested, even if they did not have symptoms. On August 25, the CDC said people who don’t have symptoms “do not necessarily need a test,” even though it’s known that people without symptoms can pass the virus to others.
Several U.S. news organizations claim the CDC was pressured to revise its testing guidelines by Trump administration officials.
The American Medical Association issued a statement saying “COVID-19 is spread by asymptomatic people. Suggesting that people without symptoms, who have known exposure to COVID-positive individuals, do not need testing is a recipe for community spread and more spikes in coronavirus.”
The leading U.S. doctors group also asked the CDC and the Department of Health and Human Services to provide the scientific justification for this change in testing guidelines.
In an email to VOA, CDC Director Dr. Robert Redfield said the agency is placing emphasis "on testing individuals with symptomatic illness"; those "with a significant exposure," such as people in nursing homes, health care workers and first responders; or people "who may be asymptomatic when prioritized by medical and public health officials."
Redfield said, "Testing may be considered for all close contacts of confirmed or probable COVID-19 patients."
Redfield's statement said the new guidelines were "coordinated in conjunction with the White House Coronavirus Task Force."