Advice on repairing public trust in the CDC


Photo: Centers for Disease Control and PreventionThis is the CDC’s laboratory test kit for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

With public trust at an all-time low in government scientists and public health agencies, what can be done to repair confidence in the U.S. Centers for Disease Control and Prevention, with an eye toward preparing for the next pandemic?

Though it may seem too early to be thinking about another pandemic, the Council on Foreign Relations (CFR), a New York-based non-partisan think tank is doing just that. On Oct. 8, the CFR issued a report – “Improving Pandemic Preparedness: Lessons from COVID-19” – to provide a roadmap for getting the U.S. out of the pandemic and respond to the next one.

“We felt it was relevant to get the information out, so it can be used to improve the [health and economic situation] now and prepare for the future,” said Sylvia Burwell, secretary of the U.S. Health and Human Services department under President Obama and co-chair of the CFR report. The other co-chair of the report is Frances Townsend, Homeland Security adviser for President George W. Bush.

Among the many recommendations within the report is to fix the public’s faith in the CDC which, until the pandemic, was a trusted resource in the U.S. and around the world.

Since then the agency’s reputation has suffered. There remain many questions about how, in February, the agency botched early testing of SARS-CoV-2, the virus that causes COVID-19, enabling the disease to spread out of control. Since then, the White House has repeatedly interfered with COVID-19 policy decisions made by the CDC’s career professionals, and in some cases, blocked its recommendations on mask-wearing, adding to confusion about what information published by the CDC can be trusted.

At the end of September, William Foege, who led the CDC’s smallpox eradication program, urged CDC director Robert Redfield in a private letter to publicly resist the White House’s interference.

“Politics has thoroughly contaminated the scientific process,” wrote Joel Achenbach and Laurie McGinley in a story for the Washington Post. “The result has been an epidemic of distrust, which further undermines the nation’s already chaotic and ineffective response to the coronavirus.”

Despite the setbacks, the CDC, more than the Food and Drug Administration and the National Institutes of Health, is still the agency with the deep institutional knowledge and the staff to implement policies and recommendations for slowing and halting pandemics.

“FDA and the NIH cannot make a statement that changes the course of this pandemic,” wrote Foege to Redfield. “You and CDC could.”

The CFR report says Congress should appoint an independent commission to review the CDC’s record. The commission should examine the agency’s actions during the beginning of the pandemic, identify obstacles to it being able to do its job and make recommendations to understand what managerial and budgeting changes should be made to improve infectious disease surveillance, data transparency, and national testing and contact tracing strategies, to prepare for the inevitability of another pandemic.

“We recommend an independent review of the CDC,” Burwell said “We need to assess what happened and understand it … to rebuild confidence in” the agency.

The report adds that the CDC will also need money to revitalize its work. The agency’s public health emergency preparedness program to support states and localities was woefully under budget prior to the pandemic and didn’t have the staff and resources to adequately respond to a national crisis like COVID-19.

To see more details of the CFR report, click here.


Leave a Reply