The leaders of public health authorities and activist groups come together to defend the CDC and demand an end to political interference.
Frustrated by President Donald Trump’s handling of the coronavirus response, major public health organizations are mounting a widespread defense of the Centers for Disease Control and Prevention over worries the administration is sidelining its own experts and undermining trust in public health officials across the country.
The nearly 350 public health organizations, advocacy groups and local health departments are urging Health and Human Services Secretary Alex Azar — who has fallen in lockstep with the White House on key markers of the coronavirus response — to play a more prominent role in shielding the CDC from political interference.
“CDC continues to be the world’s premiere public health institution and should be treated as such during this pandemic,” the groups wrote in a letter on Tuesday. “We must amplify the unfettered voice of CDC, not stifle it.”
The missive comes amid growing alarm within the public health community over the damage done by Trump’s dismissals of the pandemic threat, including his refusal to endorse basic measures like mask-wearing and his insistence that the coronavirus will vanish even as cases continue to surge. At the same time, the administration has largely relegated the CDC to the background, clamped down on health officials’ public appearances and overruled key guidance for safely reopening parts of the economy.
The letter signifies the deepening divide between top federal officials leading the coronavirus response and the local officials on the front lines — a split that state and local officials told POLITICO has reached new depths nearly six months into the crisis.
“It’s amusing to me when we hear words coming out of the federal government like ‘all-of-government response,’” said Lori Tremmel Freeman, CEO of the National Association of County and City Health Officials. “It couldn’t be further, really, from the case.”
In a statement, HHS spokesperson Michael Caputo said the CDC “has been at the forefront of this whole-of-America response to the pandemic since day one” and is represented on the White House task force by both Azar and CDC Director Robert Redfield.
“The CDC provides updated guidance regularly to ensure the American people as well as state and local leaders are armed with the most up-to-date information and has consistently deployed personnel to provide on the ground support," he said.
Still, public health organizations, including the American Public Health Association and the Association of State and Territorial Health Officials, concluded in recent weeks that they needed to launch an independent push to promote the efforts of the CDC and public health departments, in hopes of countering the rising skepticism and politicization of their work driven in part by Trump and his allies.
That has so far included Tuesday’s letter to Azar, as well as editorials praising and attempting to humanize public health officials. More than two dozen top state and local health officials have quit, resigned or retired during the pandemic, in some cases after being subjected to personal threats and slurs, or demonstrations outside their homes over public health restrictions.
“We are deeply concerned about increasing reports of resistance to evidence-based public health messages and threats to public health leaders and agencies,” the groups wrote, warning that such sentiments “undermine the health and wellbeing of America’s residents at a critical juncture when cases of COVID-19 are rising.”
After POLITICO reported on White House deliberations over a review of the CDC that would pin blame for the sluggish federal response on the agency, the various groups — which represent state, county and territorial health officials — began weighing a national media campaign aimed at raising awareness of public health workers and portraying them as separate from partisan politics.
“Our slant on that is, we’re requesting other leaders to step up in defense of public health leaders,” said Marcus Plescia, the chief medical officer for ASTHO. “It’s not clear who in the administration is an advocate for CDC right now.”
Those discussions are still in their early stages, and any resulting effort could take a variety of forms. Freeman said one large-scale idea under consideration is an awareness project that would rank as “one of the largest PR campaigns in recent history,” though she acknowledged it would require first finding the necessary funding.
Others described a range of attempts to better coordinate and promote public health messages throughout the nation, in a bid to elevate measures like mask-wearing and social distancing precautions that remain the best options to date for slowing the virus’ spread.
The need for public health organizations to consider such approaches is unprecedented, health experts involved said, reflecting both the CDC’s absence as a central messenger of the response and the portrayal of public health issues through a sharply political lens.
As the nation’s leading public health authority, the CDC has historically led federal efforts to beat back public health threats like the H1N1 and Zika viruses, enjoying support across partisan lines in the process.
But the agency came under fire early in the coronavirus pandemic over its development of faulty diagnostic tests and was further sidelined as the White House’s coronavirus task force commandeered control of the federal response.
While the CDC has continued to aid state and local officials behind the scenes, it’s received relatively little attention from the administration or the news media. That’s made it more difficult for those local health departments to organize a response around the agency’s day-to-day recommendations and obscured the agency’s work in grassroots communities.
“Certainly there have been some problems with CDC’s response,” said John Auerbach, president of the nonprofit Trust for America’s Health. “But overall, I think the CDC’s response has been strong, and the people there continue to provide really useful guidance and materials that may not be as widely recognized as it could be and should be.”
More broadly, public health organizations organizing the CDC’s defense expressed fears that the White House’s focus on reopening the economy — and downplaying the coronavirus’ resurgence — is hampering the nation’s response by turning basic health recommendations into political acts.
Trump has flouted the CDC’s recommendation that people wear face coverings in public, and waved off the pandemic’s rebound even as the nation registers near-daily record new cases. Top White House officials have similarly spurned suggestions that the administration refocus on containing the virus, touting decreases in the daily average death toll and betting heavily on the development of a vaccine by the end of the year.
And there remains little indication that the CDC and other top administration health experts will be given a freer hand to guide a response that the federal government has said must be run primarily by states and localities.
That’s left those front-line public health officials increasingly worried that even as the crisis spirals and coronavirus deaths exceed 130,000, they are gradually losing the ability to reach and influence substantial portions of the population.
“It is truly unprecedented,” Freeman said. “And I think the biggest frightening thing to me is that we don’t want this to leave a lasting impression on people that they can’t trust public health.”
