CDC criticized for inability to communicate, promises to do better

The Centers for Disease Control and Prevention held a telebriefing on Friday.

Director Rochelle Walensky chaired, along with two career scientists. The stuff was notable – update COVID-19 Tips for K-12 Schools.

But even more notable was the fact that the briefing was taking place.

It was the first such briefing in months, despite the ongoing pandemic crisis.

This lack of regular communication has sparked criticism of the agency. In recent days, public health experts have called on the CDC to confusion of isolation and quarantine guidelines, and asked the agency to communicate more often and more clearly.

A broken promise

In fact, the Biden administration has repeatedly promised to put career scientists at the forefront in its COVID communications. But these experts have typically not appeared outside of White House COVID-19 response team briefings, which typically occur several times a week, but typically only feature people appointed by politicians, including Walensky. .

This is not the same as a briefing by subject matter experts, sharing what they know with the press and the public.

“The point is, there are dedicated scientists at the CDC who are world experts in a lot of these issues, and they need to speak directly to the public with Dr Walensky,” said Dr Tom Frieden, director. of the CDC during the Obama administration, which now heads Resolve to save lives, an initiative to help governments and outside groups prevent epidemics.

CDC responds to these accusations of inadequate communication. The agency decided to hold the briefing on Friday, Walensky told reporters on the call, because “we had clearly heard over the past week that there was an interest in hearing each other independently.”

“It’s tough and I am committed to keep improving,” she said. “I anticipate this will be the first of many briefings, and I look forward to them.”

Frieden agrees: “I hope this will be an inflection point in restoring confidence in the CDC,” he said. “The more the CDC can speak directly to the public by following its own principles of health emergency communication, the better off we will all be.”

For the CDC, COVID-19 briefings have been unusually rare

The idea of ​​speaking out during a public health crisis is not new. “CDC literally wrote the book on how to communicate in a health emergency, ”says Frieden. He has clear principles to stand for, he says: “Be the first, be right, be credible, be empathetic, and give people practical and proven things to do to protect themselves, their families and their communities.”

Glen nowak, who previously headed media relations for the agency, says media briefings are an important part of his mission. “As a general rule, if there is a health development where it makes sense to educate the American public and give them recommendations and advice on what to do about it, then media briefings are really. useful, ”he says.

When the H1N1 epidemic started in 2009, “we held a press conference every day for eight weeks, including weekends,” Nowak explains. “We did press conferences as long as we had something new, something different, there was a need to do it.”

The idea was not just to inform the public. At press briefings, says Frieden, “often smart journalists ask tough questions, and we realize, ‘Oh, we haven’t said that as clearly as we expected,’ or, ‘We didn’t think about it, we “better tackle this problem”. ”

When SARS-CoV-2 was identified in China, the CDC appeared to be following the playbook.

In mid-January 2020, Dr Nancy Messonnier, then director of the CDC’s National Center for Vaccination and Respiratory Diseases, hosted the CDC’s first telebriefing on the subject. She was joined by another career scientist, Dr Marty Cetron, director of the CDC’s Global Migration and Quarantine Division.

“Since the MERS and SARS epidemics, we have improved our capabilities in the United States and around the world,” Messonnier told reporters. “We are now better prepared to respond to this new threat quickly and collaboratively. ”

These briefings continued every few days, until one drew attention to America. At February 25, 2020, Messonnier warned that “it could be bad”.

“I had a conversation with my family over breakfast this morning and told my kids that while I didn’t think they were in danger right now, we as a family should. prepare for a major disruption to our lives, ”she said. noted.

After his comments, the financial markets collapsed. President Donald Trump, whose message was that the pandemic was of low concern and under control, was so angry with Messonnier that he wanted her to be fired. The next day, he appointed Vice President Mike Pence in charge of the White House coronavirus task force. COVID-19 televised briefings have become a White House affair. The CDC director was usually not present.

The CDC telebriefings have continue for a while – although occasionally.

Under Biden, the CDC still seems sidelined

President Biden took office promising to defeat the pandemic by restoring public confidence.

“Scientists and public health experts will talk to you directly – which is why you are still going to hear a lot more from Dr Fauci – not from the president but from real experts and scientists,” Biden promised the day after his inauguration.

True, Americans have heard a lot about Dr. Anthony Fauci of the NIH – the president’s chief medical adviser – and Walensky of the CDC. The two are frequent guests on TV news shows and White House briefings on the COVID-19 response, which typically take place several times a week.

But, under Biden, the CDC and its career scientists still seem to be sidelined. The CDC has actually done fewer telebriefs on the pandemic under Biden.

In 2020, under Trump, there were approximately two dozen CDC telebriefings.

In 2021, under Biden, there were two.

Dr Céline Gounder, an infectious disease specialist and epidemiologist at NYU who views Dr Walensky as a mentor, said she hoped to learn more about the CDC’s career scientists in the new administration.

“I’d like to know more about them about – what’s the science they’re doing?” How do they do it? What is their process? ” she says. “I think there is something to be said for just giving a human face to some of these things,” she adds, which the public does not understand when changes in focus occur through the website. of the CDC.

She calls Walensky’s promise to bring back regular briefings “good news.”

Politics and a pandemic don’t necessarily mix

The administration appears to be treating the pandemic as a political issue that must be managed politically, says Gregg Gonsalves, epidemiologist at Yale.

“There has to be a lot more openness and transparency on the part of the White House, and they have to let their scientists off the leash,” he says.

A primary problem may be a conflict between politics and public health.

Political messages should be simple. But that doesn’t work for infectious disease messages, Nowak says. “The situation is much more dynamic – viruses change a lot and can change in a way that makes your recommendations less effective,” he says. “With communicating about infectious diseases, you really have to recognize the uncertainty.”

Yet in the 14 years he worked at the CDC, the Democratic and Republican administrations, he said the trend seemed to be for the White House to exercise increasingly tighter control over messages.

“You have to be prepared to believe that the scientists and the experts doing these briefings are going to do what needs to be done,” he says. “And this administration is not unique, not by any stretch of the imagination in terms of a willingness to trust career scientists.” That is, they don’t seem to trust them too much, he adds.

Walensky’s pledge to hold more briefings “is a useful development,” he says. “The question is going to be how often they commit to having regular press briefings, what are the topics, what are the messages.”

The CDC did not respond to NPR’s question about how often the agency plans to hold agency-led briefings.

Frieden hopes the CDC will keep its promise and speak directly to the public more often.

“It’s better for everyone,” he says. “It’s better for the CDC because they can explain themselves. It’s better for the administration because you’re better off if you have a CDC that people trust. And it’s better for the public. because you can understand the guidelines. ”

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