6 ideas to make the CDC great again
It will be a long time before Americans forget the Centers for Disease Control’s failure to control the COVID pandemic. While president-elect, Trump summed it up well: “Americans have lost trust in the CDC and our Federal Health Authorities, because of censorship, data manipulation and misinformation.”
The lack of trust in the nation’s primary public health agency is a tragedy of the CDC’s own doing. The agency’s constantly changing advice on masking, social distancing and hand washing all proved pointless during the pandemic. And, by failing to do appropriate clinical trials and describe the potential dangers of COVID-19 vaccines, the CDC added millions to the ranks of anti-vaxxers.
The CDC’s incoming head, former Congressman Dave Weldon, a physician, has been commissioned by Trump to “focus on the prevention of disease.” In the eight decades since its creation, the CDC has become an emblem of governmental mission creep.
Its mismanagement of COVID reflects how the agency has expanded its remit to many complex social problems including gun violence, homelessness, obesity and loneliness, that have been erroneously cast as “epidemics.”
The gauge of real epidemics is whether they respond to the canonical interventions of public health — detecting a new communicable threat, tracking and informing those infected before they are symptomatic and infective, quarantining and developing a vaccine.
Weldon might immediately get Elon Musk and DOGE to see gun crimes as the business of the Justice Department just as matters related to homelessness belong in Housing and Urban Development, obesity is the appropriate focus of the National Institute of Diabetes and loneliness belongs to the National Institutes of Mental Health.
Similar CDC programs to reduce heart disease, improve worker safety and many others conditions should be turned over to existing agencies formed to work on these problems.
Once the CDC is appropriately downsized to concentrate on communicable diseases, work that occupies less than ten percent of its current workforce, Weldon should consider five additional steps intended to upset the agency’s culture.
- Purge the CDC of its commitment to DEI. Unbelievably, in March 2020, the agency issued an across-the-board recommendation against gatherings of more than 50 and warned against "conferences, festivals, parades, concerts, sporting events, weddings and other types of assemblies," essentially declaring that all Americans were at equal risk of contracting COVID. This decision was at odds with established epidemiological thinking that requires first identifying segments of the population at greatest risk of fatality and making them the immediate focus of preventive measures. The CDC knew that 70 percent of hospital admissions for COVID-19 were patients over 65 and that they reflected the racial and ethnic composition of the general population. Yet, months later when the COVID vaccine was first available the CDC again determined its distribution required targeted outreach based on economic status and racial/ethnic identity — not more imminent risk of mortality or morbidity.
- Let the public see the data. From the first, the CDC resisted access to data related to hospitalization rates, booster shots and wastewater data related to COVID. In February 2022 the New York Times reported the agency had released “only a tiny fraction of its COVID-related data,” likely to frustrate nongovernment scientists from proposing alternative approaches to managing the epidemic. Imagine if parents knew that the CDC’s own evidence showed that school-aged children were overwhelmingly the least likely to contract the COVID-19 virus.
- Ignore experts who’ve abandoned the scientific method. Not one professor of public health appeared to notice the CDC’s failure to share COVID data. Similarly silent when the CDC declared we were all at equal risk, it took the authors of the Great Barrington Declaration to argue for targeted prevention. Predictably, the American Public Health Association opposed their recommendations as “not based in science” just as it disputed the effectiveness of herd immunity, long established as the most effective way pandemics end. Ideological epidemiologists are not what the nation needs.
- Hire a new general counsel. Unimaginably the CDC declared a nationwide moratorium on evictions during the pandemic arguing that moving somehow presented a higher COVID risk. The agency was swiftly reversed by the Supreme Court for attempting such an overreach. Pandemics do not void Constitutional protections of liberty.
- Personally oversee public communications. While the CDC was slow to recognize the danger of COVID its permanent bureaucracy appears to be overly zealous in identifying possible new epidemic threats judging from the velocity of recent alerts. Needlessly worrying the nation about monkeypox and bird flu will only serve to further reduce the effectiveness of warnings when serious future threats might be at hand.
- Inquire about the CDC’s ghosting its self-reform plan. Two years ago the CDC announced a two year effort to remake the agency and “modernize” its data assets. While the CDC’s website periodically reported on the project, including its 161 goals, recently any reference to the project has disappeared. Has the CDC’s staff has now decided that reform is not necessary?
The CDC is a broken agency. President Trump and Weldon have a lot of work to do, but the good news is that they have a mandate to act.
Carl Schramm is a university professor at Syracuse and a fellow at the Johns Hopkins Institute for Alternative Economics, Global Health and the Study of Business Enterprise. He was a member of the COVID Crisis Group, co-author of its report “The War on COVID,” and the author of “Burn the Business Plan” (Simon & Schuster).
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