Former CDC director: The agency's unscientific moves to end asymptomatic testing are 'undermining trust in government' and risking people's lives
- The Centers for Disease Control and Prevention is drawing scrutiny from scientists and public health experts this week for its shift away from recommending COVID-19 tests for "all close contacts" of people with confirmed cases of the coronavirus in the US.
- Dr. Tom Frieden, who ran the CDC from 2009 to 2017, called the move "dangerous" and "not scientifically supportable."
- He said the move is "self-defeating" for the federal government because it will erode trust from the public.
- "Trust is an essential component of any epidemic response," he said. "Anything that corrodes trust risks lives."
The Centers for Disease Control and Prevention has been confusing Americans for months about what to do to stay safe and disease-free during the coronavirus pandemic.
From the early days of the outbreak and the CDCs flawed testing strategy, to an about-face on mask wearing, and its shelving of proper guidance for reopening businesses and schools, almost nothing the agency has recommended during the pandemic has been clear or unwavering.
Earlier this week, the agency again confused public health experts and lay-people alike when it changed course on testing recommendations for the coronavirus.
The CDC had previously maintained that "testing is recommended for all close contacts" of people who have a confirmed case of COVID-19, the disease caused by the coronavirus.
According to the agency's current best estimates, 40% of COVID-19 cases may be asymptomatic and asymptomatic patients are about 75% as infectious as symptomatic patients, so they can get others sick.
However, in a shift to its nationwide guidance on Monday, the agency said that "you do not necessarily need a test," for COVID-19 unless you are symptomatic, with tell-tale signs of the virus, like a fever, headache, or cough — even if you've been in close contact with someone who has a confirmed coronavirus infection.
On Wednesday, CDC Director Robert Redfield unofficially walked back the change after uproar from health departments and scientists, saying that "testing may be considered for all close contacts of confirmed or probable COVID-19 patients."
But the damage to the agency's scientific credibility had already been done, and a former head of the CDC says it's indicative of a clear and problematic shift for the agency, which until this pandemic, has operated with a fair degree of scientific autonomy from higher-ups in Washington DC.
'Dangerous' and 'not scientifically supportable'
Former CDC Director Tom Frieden, who directed the agency from 2009 to 2017, says this is not how the CDC usually operates, and it's "a big problem."
"I don't think there has ever been a time before when people from the White House or HHS are dictating what goes on technical documents on the CDC website," Frieden told Insider during a question-and-answer session on Thursday. "This is dangerous."
The recent change in recommendations for asymptomatic testing mirrors what happened with the agency's guidance for schools and businesses, in May and June. Changes were handed down to the CDC from above, ignoring scientific evidence. In the case of testing guidelines, they were changed after a White House Coronavirus Task Force meeting last week (a meeting the task force held while Dr. Anthony Fauci, a key member, was away having vocal chord surgery).
These mandates from above "are frankly not scientifically supportable," Frieden said.
"That's problematic because it undermines our trust in government," he said, calling the move one that's ultimately "self-defeating."
"Trust is an essential component of any epidemic response," he said. "Anything that corrodes trust risks lives."
Despite Redfield's backtracking statement, the agency's official guidance on its website still maintains people without symptoms don't necessarily need COVID-19 tests. The CDC does not mention anything about a self-imposed quarantine for asymptomatic or pre-symptomatic people, despite widespread evidence that people who have the virus can transmit it well to others, especially in the critical early days and hours of an infection, just before people may start showing signs of sickness.
Americans trust the CDC a lot more than the President, but that could change
Despite all the confusion, recent polling suggests that most Americans still trust the experts at the CDC with their health, but that could change, if the agency's edicts and advice continue to take unscientific edits from above.
A June 2019 nationwide survey conducted by the non-partisan Pew Research Center suggested that 64% of the country said the CDC gets its facts right about the pandemic "almost all" or "most" of the time, while only 30% said the same of President Trump and his administration.
If the agency becomes increasingly seen as his administration's mouthpiece, it could undermine its public credibility further, which would have devastating consequences for ending this outbreak, Frieden said, particularly in the months ahead, as Americans weigh whether to get a vaccine.
"It's likely that some vaccines will be shown to have some effectiveness in the coming months," he said. "We'll need to know, are they safe? Who do they work for? Who should get them first? And that kind of question can only be reliably answered and believed if that trust is maintained."
It's totally normal to have a little back and forth, in discussions and policy debates among different agencies and sections of the federal government, Frieden said, but "until this pandemic, [CDC] has had a respected autonomy within the federal government."
It's high time to bring that kind of autonomy back to Atlanta, he said.
"At CDC there are thousands and thousands of hard-working scientists, experts, doctors, PhDs who care deeply about protecting Americans," Frieden said. "I hope they can get back to that work, and do that without political interference."