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The CDC director is seen as letting the agency strain to political influence



IRobert Redfield named the Atlanta-based agency its first address to the Centers for Disease Control and Prevention staff as the best science-based, data-driven agency in the world.

His voice broke repeatedly as he unsuccessfully tried to hold back tears, Redfield – appointed director of the CDC in March 2018 – told thousands of staff he had long dreamed of leading the prestigious institution considered the gold standard for public health agencies and globe. He made a solemn vow to them.

“My promise to you is that I will work to continue this legacy,” said Redfield, a virologist and physician specializing in the care of people living with HIV. “We are not an opinion organization. We are a science-based, data-driven organization. That is why the CDC has the credibility that it has all over the world. ”

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Now, 2 1

/2 years into his tenure, the magnificent agency finds itself in new and treacherous waters, its reputation is colored and its staff morale by a historically low, current and former CDC insiders told STAT. Many say Redfield is not doing enough to protect the CDC’s reputation and the integrity of its work, and that he is failing to fend off political interference that is undermining Americans’ trust in the organization.

“I find it worrying that the CDC director has not been overt when there has been a case of clear political interference in the interpretation of science,” said Richard Besser, a former CDC director and now president of the Robert Wood Johnson Foundation .

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Former CDC staff, a number of whom exchange concerned emails lamenting the agency’s condition, are deeply troubled but cautious about speaking out. A former official said current staff are in trouble over what to do. “Even if you got a dozen of them to resign at the same time, it’s a day’s story,” the former official said.

Others were willing to speak in public.

“I think [Redfield]We do not show the kind of leadership in the defense of the institution and in the defense of science that I hope to see, ”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. It’s awful, ”said Rosenberg, who is now retired but remains in contact with former colleagues.

Public health experts at the CDC, who led the country’s responses to countless threats over decades – the deadly outbreak of HIV, the 2001 anthrax attacks, SARS, the H1N1 flu pandemic and Ebola – have been sidelined by the administration amid President Trump’s re-election campaign.

On several occasions, guidance documents written by CDC staff – recommendations intended to be the most up-to-date distillation of the new science of the SARS-CoV-2 virus – have been revised by policy makers in Washington to reflect administrative goals.

Guide to Helping Churches Resume Personal Services in May originally recommended that the use of choirs be suspended or at least diminished due to evidence that choirs had been linked to a number of super-spreading events, including one in the state Washington. However, that advice was removed, according to the Washington Post, citing objections from Vice President Mike Pence’s office.

Former CDC director Tom Frieden – Redfield’s closest predecessor – called the revision “indefensible. It endangers people’s lives.”

During the summer, officials in Washington also reportedly intervened to change the guidelines on whether or not to reopen schools. The guidelines were changed to suggest that the CDC felt that opening schools was of paramount importance, whether or not it would spread Covid-19.

“They worked on the school’s guidelines for several months,” Rosenberg said of the CDC staff. “Around the clock, they worked 24/7 to get the best scientific guidance to the country. And then … The White House put an introduction on the front page of it on the CDC website that said, ‘The most important thing is that kids go back to school.’ It was not written by the CDC. That was not something the CDC people wanted to say. ”

Most recently, the guidelines on who should test for Covid-19 were changed to recommend against testing people who had been in contact with cases but who were asymptomatic. In fact, it is key to contain the spread of the virus to find humans as quickly as possible so that they can be asked to isolate. “This is a fundamental misunderstanding of what public health is,” Frieden said.

The change in the test councils led to the extraordinary publication of an op-ed in the New York Times late last month urging public health officials around the country to “ignore the CDC.” It was written by Harold Varmus, a former director of the National Institutes of Health, and Rajiv Shah, president of the Rockefeller Foundation.

In recent days, first Politico and then other news organizations have reported that Washington officials have tried to revise or delay the publication of scientific reports in the CDC’s online journal Morbidity and Mortality Weekly Report. MMWR is, as it is better known, a foundation of public health. This is where the first reports of AIDS cases in the United States were published; this is where public health workers looking for the latest in an outbreak or illness first come into play.

Michael Caputo, communications director for the Department of Health and Human Services and his scientific advisor, Paul Alexander, a sometimes part-time associate professor at McMaster University in Canada, had reportedly demanded to read and modify MMWR articles before they were published. Caputo has denied having read MMWR articles prior to publication.

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

In a written response, the CDC director sidestepped all of STAT’s questions – about political influence on guidance documents, revisions of MMWR articles and his own commitment to protect the agency’s reputation. Instead, he said he believes the CDC “remains the world’s leading public health agency.”

“I believe without a doubt that CDC science, data and service have had a huge impact on saving human lives” in the pandemic, Redfield wrote.

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

But sources tell STAT that Redfield is not a good listener. This is a shortcoming he seems to be aware of; In his March 2018 speech to CDC staff, he said his wife, Joy, had given him a to-do list for his new job: “The first was ‘Listen.’ The other was, ‘Do not interrupt.’ The third was ‘Listen.’ ”

Redfield did not come to the CDC with a background in public health. And he fights as a communicator and erodes his ability to speak for the CDC’s positions, a number of sources suggested. At meetings of the White House Coronavirus Task Force, it is said that he often refers to the more confident Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Although he has stepped into the breach left by the CDC director, Fauci is not a trained public health expert either. Like Redfield, he is a virologist and HIV clinician.

Besser admitted he does not know if or how hard Redfield is fighting for the CDC behind closed doors; Frieden noted that it has been reported that the CDC director pushed back to the issue of MMWR.

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

“The CDC director – and this applies to everyone in management – has to look at himself and say: ‘There is a line I do not want to cross. And there is a line that I will not allow others to cross if it undermines the value of the agency, ”Besser said. “And again and again in this pandemic, we have seen political actions that have undermined the CDC’s credibility and undermined public confidence in the CDC. And we have not seen a strong defense by the CDC director. ”

“What we are seeing now is an erosion of that confidence,” he said. “It is harmful and will cost lives.”




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