How the CDC failed local public health officials fighting the coronavirus
Sep 16, 2020 7 mins, 18 secs

The week America lost the fight against the new coronavirus, the nation’s premier health agency promised local officials it had the virus under control.    .

They punted questions from state officials worried that returning travelers could spread the coronavirus when they showed no symptoms. .

As the virus raced across America, state and local authorities sought help from the CDC, the $7 billion federal agency established to lead the nation through a pandemic like this.  .

Reporters reviewed 42,000 pages of emails and memos obtained from local health departments and interviewed more than 100 community leaders and public health experts, including current and former CDC officials.  .

But these interviews and records provide the most extensive look yet at how the CDC, paralyzed by bureaucracy, failed to consistently perform its most basic job: giving local public health authorities the guidance needed to save American lives during a pandemic.  .

At times, rank-and-file CDC representatives, aware of their own leadership’s lagging response, told state health departments to consider adopting guidance from academic studies or other states. .

In the most extreme cases, the CDC undermined local health officials advocating a more aggressive approach to control the spread. .

The agency went so far as to edit a government science journal in late March to remove a Washington state epidemiologist’s call for testing throughout senior assisted-living facilities.

The CDC declined to make senior leaders available for interviews and did not answer detailed questions about USA TODAY’s findings. In a statement emailed by CDC spokesman Tom Skinner, the agency said it has executed its mission to protect Americans and worked to support state and local health departments with accurate information.

The pandemic has presented unprecedented challenges and many health officials told USA TODAY they were grateful for the CDC’s help.

The White House also handicapped the agency from the start.

Still, former CDC officers who held senior leadership roles under Republican and Democratic presidents told USA TODAY the agency that once commanded global respect collapsed just when local communities needed it most.  .

Local health officials and even the staunchest CDC champions lambasted the move.

Brent Pawlecki, the chief health officer at Goodyear, told agency leaders in July as a panel of independent scientists reviewed the agency’s early response.

“I don’t think people understood,” Crystal Miller, health director for four counties in the area, told USA TODAY.

For two weeks between when Donohue fell ill and when the governor shut down the state, Barnett, the judge, said he did not realize how much the small city of Cynthiana was at risk. .

I am a farmer,” Barnett told USA TODAY.

“This is next to impossible for provider practices to accomplish,” Andrea Flinchum in Kentucky’s health department told the CDC in a March 10 email.   .

Matthew Penn, director of the CDC’s public health law program, told a lawyer in the state’s health department not to ban nursing home visitors outright.  .

Muhammad Babar, a geriatrician at the University of Louisville advising the state on coronavirus care at long-term care facilities, told USA TODAY that following the CDC lawyer’s advice “would have resulted in a disaster.”  .

In its statement to USA TODAY, the CDC noted that the agency had sent approximately 1,300 public health experts to conduct more than 2,000 investigations in states to combat the pandemic.

The agency said its guidance was tailored around keeping communities “informed of the evolving science and changes to guidance through routine, direct and transparent engagements.” .

Headquartered in Atlanta, removed from the direct line of politics, the federal agency employs thousands of public health experts, many embedded in local health departments.

Public health experts, including former CDC officials, have accused the agency of creating guidelines on crucial measures like testing based on supply shortages, not science.

Jim Curran, an epidemiologist at Emory University who previously led the CDC’s research into HIV for 15 years, told USA TODAY.

Sachita Shah told USA TODAY.

The CDC said in its statement provided to USA TODAY that the early testing protocol was “based on the epidemiology of the disease at the time.” CDC senior officer Dr

Nancy Messonnier told reporters in February that the agency green-lighted testing for the patient when it became aware of the case

Vish Viswanath, a health communication professor at Harvard and an independent scientist on the CDC’s advisory board, told the agency during a July review panel

The breakdown in the agency’s communication with local communities contributed to the failure of the Trump administration’s signature defense against the pandemic: restrictions on travel from hotspots in China and later around the world

At the Los Angeles airport, where the flight had been temporarily redirected, officials with the CDC’s quarantine and mitigation division told her they were unaware of the requirements drawn up by their own colleagues

“It’s hard to imagine that would happen,” she told USA TODAY

The agency knew it had work to do around data management, scientific readiness and domestic operations after reviewing its response to recent emergencies such as the Ebola and Zika outbreaks, according to minutes from a 2018 meeting of outside experts who advise the CDC’s Center for Preparedness and Response

“This pandemic has spotlighted shortcomings within our nation’s public health system, including the need for long-term and sustained funding for state and local health departments,” the agency said in its statement. 

William Schaffner, an infectious disease specialist at Vanderbilt University and a former CDC investigator, told USA TODAY the scientists working on HIV do not even coordinate with those concentrating on preventing and treating other sexually transmitted diseases.  

“Hearing word of people already leaking through screening system,” Penn, the director of the CDC’s public health law program, wrote to colleagues and lawyers in several state health departments

At one point, the agency told employees at the Los Angeles airport not to screen private charter planes, which are “mainly for rich people.” Flight attendants in Dallas witnessed travelers from China entering without a second look

“The customs agent told them ‘not to worry about it,’” state officials wrote to the CDC in February

While the student and his roommate quarantined in an apartment on campus, the CDC did not tell state health departments about other travelers who might have come into the state from Wuhan

Looking back, Norman told USA TODAY, “we just never had a great deal of information.”  

The agency did not manage to ensure the safety of more than 2,000 travelers on a single cruise ship, the Grand Princess, after an outbreak led to quarantines at military bases in March

State and local authorities are supposed to look to the CDC in a public health crisis

“It’s unconscionable that that’s happening,” said Nancy Cox, former director of the CDC’s influenza division, who worked at the agency for 37 years.  

The agency also tried to soften a public health officer’s early warning about the coming spread of the virus in Placer County, California. 

Aimee Sisson, who had previously worked in the state health department, pushed ahead anyway, including a strong warning in her news release: “We expect to see additional cases in coming days, including cases of community spread, not linked to travel.”

She told USA TODAY that she felt confident the virus was already “out of the bag.”  

The Trump administration began to publicly sideline the agency and attempt to overrule its decisions. 

“CDC’s role always is going to be defined by an administration,” CDC scientific advisor and longtime public health expert Alonzo Plough said in an interview

Recently, following pressure from the White House, the CDC blindsided local health officials by revising its testing guidance yet again to say that people exposed to the virus but not showing symptoms do not necessarily need to be tested

The agency said that shift still allows for testing when public health officials and doctors think “there is the need for action tied to a diagnosis – for example isolating infected individuals and quarantining close contacts.” 

“This premier public health agency that trained me, and has produced so many public health leaders, is now really not able to implement their mission, which in part is to support state and locals,” she told USA TODAY


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