The Centers for Disease Control and Preventions has defined the COVID-19 pandemic as the United States. However, there is still confusion about how to stop the spread. It was a difficult decision. FiveThirtyEight's Maggie Koerth searched for the answer and discovered that the CDCs instinct toward caution made it difficult to fight COVID-19. Politics didn't help either.Below is a slightly edited transcript.Dr. Anne Schuchat: This virus makes everything seem a lot scarier than it initially seemed.Dr. Anthony Fauci says: While we don't have the money we need, we still go full-blast by borrowing money from other areas. President Obama asked for $1.9billion. We needed $1.9billion.Maggie Koerth - That was Dr. Anne Schuchat (ex-principal deputy director at CDC) and Dr. Anthony Fauci (whose voice you may recognize). They were not talking about COVID-19 as you might think. They were talking about Zika.Dr. Margaret Chan: Experts agree that there is a strong causal link between microcephaly and Zika infection in pregnancy. However, this has not been scientifically proved.Dr. Sonja Rasmussen. The first indication that Zika could be linked to birth defects was in Brazil. Doctors noticed that there were a lot of babies born with severe microcephaly (an abnormally small head). In April, the CDC confirmed that Zika was a factor in microcephaly as well as other birth defects.Maggie Koerth: This is Dr. Sonja Rasmussen talking about Zika back in 2016. She held various leadership positions at the Centers for Disease Control and Prevention (CDC) and was a co-author of the paper that clearly identified Zika as a source of birth defects.Dr. Sonja Rasmussen said: This was the most important thing I've ever done. I have never claimed anything to be definite. I used to wiggle and then suddenly I was saying that something was causing birth defects. It was that day I felt like I was going headfirst off of the high dive. We wanted people to trust us.Maggie Koerth: People need to be able to trust their information when their lives are in danger. The CDC is the U.S. government's trusted source of information. Despite the obvious fact that Zika was causing birth defect, the CDC waited to give a definitive answer. It was criticised for being too slow and too fast when it finally gave an answer.The same trend has been observed with COVID-19. The CDC wiggled about whether it was possible to stop wearing masks after we had been vaccinated. It also questioned whether the disease could be transmitted by air. And who should have access? It wants to be sure so it usually waits for the critical mass of scientific evidence before declaring anything. This takes time. This pandemic was a disaster. The communication with the public seemed worse than usual. It also led to a significant loss of trust.Nearly a dozen scientists spoke with me over the past month and all agreed that the CDC could have done more. It will be difficult to correct the root causes of the CDC's failures.Im Maggie Koerth and I am Anna Rothschild. This is PODCAST-19 at FiveThirtyEight.Dr. William Schaffner served as an epidemic intelligence officer at the CDC. He is now the medical director for the National Foundation for Infectious Diseases and works with the CDCs Advisory Committee on Immunizing Practices. He said that there was a solution for every public health problem.Dr. William Schaffner : They have economic, cultural, and social dimensions, all of which involve the political leadership. Public health is not possible without acknowledging that public policy requires partnership with any political structure at the time. It's like walking tightropes.Maggie Koerth. In 1976, the government had a decision to make about who should be vaccinated against a possible swine flu pandemic. While some experts believed that the threat of a pandemic was low CDC believed there were high risks. They advocated mass vaccination, which was expensive.Gil Eyal: A campaign to balance risk calculations.Maggie Koerth: Gil Eyal, a Columbia University professor of sociology, is Maggie Koerth.Gil Eyal: It's hard to find the right balance between the fear of it being really catastrophic and the fear that it will be one of those rare cases where you can cry wolf.Maggie Koerth. At the time, President Ford ran for office and did not want to be responsible in any way for a pandemic. He complied with the CDC's advice and vaccinated 45,000,000 people in 10 weeks. The pandemic did not occur because this flu strain had a low transmission rate. The political calculations backfired in that instance, and the CDC was forced to pay the price of less public trust. This is exactly what Dr. Fauci wanted to avoid with the pandemic. This is him speaking at the Aspen Institute, February 2020.Dr. Anthony Fauci, Is there a chance that this will become a global pandemic. Yes. It is. We always follow. At the moment, the risk is very low. We take this seriously. The situation could change. There is a high chance of being completely destroyed and then nothing. Your credibility will be gone.Maggie Koerth The CDC has a constant problem with the fear of being aggressive.The agency was also confronted with political interference during this pandemic. In September 2020, leaked documents revealed that Health and Human Services staffers had tried to alter COVID reports from the CDC because they didn't align with Trumps views on the pandemic and his plans for dealing. To downplay COVID's death toll, officials in the administration wanted the report to also include deaths due to suicides and heart attacks. Separately, the White House pressured the CDC to limit press conferences. This effectively excluded the agency entirely from its briefings.Maggie Koerth. Experts told me at the same time that Trump's CDC was not working with outside experts as it did in the past. Usually, the executive branch supported the CDC and other agencies in building what's known as a Team B of outside experts. These outside experts were brought in to review and analyze CDC research and to offer alternative perspectives. Experts I spoke with said they didn't know why these groups were not formed, but that it had a significant impact on our response. If the CDC had worked more closely with health care facilities, it would have been easier to roll out certain treatments for those most in need.Multiple experts said that the CDC was isolated from the rest the scientific community, and the public due to political interference. The CDC was the only one who could speak to them.Dr. Richard Besser says that without CDC, there would have been more voices. Social media is just one way people can communicate.Maggie Koerth: In 2009, Dr. Richard Besser was the acting director at the CDC. However, social media has seen a lot of change since then.Dr. Richard Besser says that there are people with thousands of followers who drive a lot the conversation. Social media is, I believe, amplifying the gap between those who support a public-health approach and those who favor a more political approach to health. This is a way of viewing public health as a threat to the national economic recovery and health.Maggie Koerth: Experts believe that politicization was not only divisive, but also hurt scientific research quality. Vinay Prasad, a hematologist-oncologist who is also a professor at the University of California in San Francisco, is Dr. Vinay Prasad. His research has been on the changing medical norms in response to new evidence. According to him, social media has raised the stakes for COVID decision-making. Masking, for example, became almost a moral, political issue. We didn't do enough research to find out when masking is most effective.Dr. Vinay Prasad says: Scientists would never claim that masks work in a binary way. They either work perfectly or fail completely. It could be that the truth is somewhere in between. Perhaps below a certain age, the person cannot wear it with enough adhesion, so there are diminishing returns. It might work when the case rate is 10 per 100,000. But if it's 1 per 100,000 it may not. Maybe there is an interaction between the severity of the virus and its prevalence. After this pandemic, I don't think we will be able to know more than what we did in the beginning. That is quite sad.Maggie Koerth - Maggie Koerth: This murky area where there isn't a lot of peer-reviewed scientific evidence, isnt where CDC thrives. Here's Dr. Besser.Dr. Richard Besser says that if you don't have the science it can be difficult to tell people what they need to know. Is it risky for someone to wear a mask if theyve been fully vaccinated? It will take some time to receive the guidance if you are still waiting for studies. It seemed as if the new guidance had fallen from the sky when it came forward. We hadn't been invited along on the journey. We didn't see what the agency was learning.Maggie Koerth It was difficult for us to trust the agency since the beginning, as we didn't know the reasons behind CDC decisions.What does this all mean for the future of CDC? What does this mean for us? Is it possible to be better prepared for the next pandemic? Many of the researchers I spoke with didn't believe so.Dr. Schaffner believes that for real reform to take place, the CDC requires external advice.Dr. William Schaffner : I'd prefer to have some outsiders involved in an after-action report. This is not something I think the CDC excels at. You won't find problems if you don't look hard enough. You won't be able address problems if you don't find them.Maggie Koerth - But Eyal believes that our collective experience will enhance our responses to future CDC guidance.Gil Eyal says: If this happens in a year, two, or three years, the U.S. population might be similar to that of China.Maggie Koerth - Eyal stated that China was able react to COVID-19 the same way it did to COVID-19, because they had to go through SARS.Gil Eyal said that SARS was the trauma that was imprinted. Even though we may be polarized right now, I don't rule out the possibility that people will act on the memories of what happened next time.Maggie KoerthThis is it for PODCAST-19. Im Maggie Koerth. Sinduja Srinivasan is our producer. Chadwick Matlin serves as our executive producer. Thank you for listening. We look forward to seeing you again.
