DV Journal

How does an agency named the Centers for Disease Control and Prevention fail to “control or prevent” a pandemic like COVID-19?

Because it was off-mission, said Dr. Brian Miller with the American Enterprise Institute. Instead of intensely focusing on tracking communicable diseases and fighting infections, the agency wandered into “woke” issues like fighting racism and advocating gun control. When a novel coronavirus hit, the CDC wasn’t ready.

Miller, who is also a practicing hospitalist at Johns Hopkins University, laid out his case at the Common Sense Public Health Roundtable hosted by InsideSources.

“Their mission has drifted,” Miller said, turning attention and resources to “things such as the environment, racism, or gun violence.”

While acknowledging those are important issues, Miller notes they are far afield from the CDC’s responsibilities.

“Take environmental health and climate change, for example,” Miller said. “Would you like the CDC focusing on that? Or would you like the Environmental Protection Agency (EPA), which is the foremost environmental regulator?”

The CDC’s record of failures during the pandemic has been well documented.

When the COVID-19 strain was first detected in the U.S. in January 2020, the CDC was slow to act. It refused to allow private labs to create a COVID test, for example, instead sending out its own flawed version in early February. Weeks of valuable testing data were lost before the CDC reversed its position, allowing labs to create their own tests.

“The CDC wanted to have an internally developed and managed test rather than serving as a coordinated nexus and center for the development of university-developed tests, private physicians, and labs developing tests,” Miller said. “The CDC sort of lost its focus and ability to serve as a guidance, logistics, and strategy organization.”

That view is similar to that of former Food and Drug Administration director Dr. Scott Gottlieb, author of “Uncontrolled Spread.” He wrote that when the agency finally relented and allowed other organizations to make tests, “It would be weeks before commercial manufacturers could get access to the [virus] samples they needed, and they’d mostly have to go around the CDC.”

Another glaring failure was the CDC’s lack of trustworthy guidance to both medical providers and the general public.

Miller spent the pandemic months treating patients on COVID-only hospital floors and in COVID-screening clinics. When he would seek guidance from the CDC on a specific question, such as, ‘How many days should a patient remain isolated after leaving the hospital, what are the appropriate therapeutics, etc.,’ the CDC’s information was either dated, late upon arrival or, worse, it didn’t have the data.

Then there was what Gottlieb called the agency’s “single most costly intervention,” the six-foot distancing rule, which was used to keep schools closed months longer than necessary. The CDC didn’t update its guidance to three feet until March 2021, months after widely-available evidence showed three feet of distance was more than sufficient.

“Probably the single costliest recommendation that CDC made — that you had to maintain six feet of distance — that wasn’t based on good judgment and good science was ultimately changed,” Gottlieb told CBS News.

Some education experts now warn the damage from two years of lost classroom learning may never be undone.

Can the CDC be fixed?

“Superficial reforms will not fix it,” said Jane M. Orient, M.D. of the Association of American Physicians and Surgeons (AAPS). “There needs to be top-to-bottom housecleaning to eliminate conflicts of interest and political agendas and focus solely on infectious disease control.”

Instead, said Miller, in the years leading up to the COVID-19 outbreak, “the CDC wanted to remain in the news. It wanted to be an important public policy voice, and, as a consequence, its mission drifted.

“But having an organization that is trying to be all things to all people all the time means that it cannot perform its basic functions, as we discovered during the pandemic.”

How can Americans lead healthier lives?

Solutions include reforming the Food and Drug Administration (FDA) and the Centers for Disease Control (CDC), along with replacing cigarette smoking with safer nicotine delivery systems.

InsideSources recently hosted the “Common Sense Public Health Roundtable” at the National Press Club in Washington, D.C., where three public health professionals laid out simple solutions that could pack a real public health punch.

“I would replace the FDA’s human food program, and I would replace it with something that would give both producers and consumers a better choice,” said Dr. Richard Williams. “And that would address food safety and nutrition problems that are plaguing us.” Williams, author of “Fixing Food: An FDA Insider Unravels the Myths and the Solutions,” worked at the FDA for nearly 30 years. “We treat FDA like it’s a revered institution when in fact, it’s like an old company that’s selling outdated products.”

The FDA is 117 years old, Williams noted, and “things are going on that they can’t keep up with.” He said while the most recent problem was the infant formula shortage, there have been a variety of other issues, especially with food safety and nutrition.

Thanks to a lack of innovation and little pressure from the public to improve, the results are underwhelming.

Every year, the FDA goes to Congress and asks for more money, making the same claims: 48 million people are getting sick from food-borne diseases, 128,000 are hospitalized, and 3,000 die Williams noted.

“Nobody ever says, ‘You’ve been saying the same thing every year, and we keep giving you more money, and nothing’s happening,’” said Williams. “They write regulations… They’re out of ideas, and unfortunately, we all pay for this” with taxes, higher food prices, illness, and death.

“Should almond milk be called milk? They spent a couple of years trying to figure that out,” said Williams

“Nutrition is a bigger problem,” he said. “Four out of 10 people are obese in this country.” Half the population will be obese by 2023. And food labels don’t help. Since they started labeling in 1973, “half of us now are diabetic or pre-diabetic. Heart disease and cancer are going up.”

“In 2020, COVID killed 350,000 people in this country. Poor nutrition killed 500,000,” said Williams. And the FDA still uses “old science.”

He suggested the FDA use a model like DARPA (Defense Advance Research Projects Agency) where the bureaucracy is minimal, and the agency can “develop new ideas.”

Among the steps, Williams suggested: Foods made in 3D printers; using robots in food production and intelligent packaging to signal that food is spoiled; and wearable nutrition devices that tell you what to eat and how much.

Clive Bates, editor of “The Counterfactual,” offered a basic yet bold public health policy. “Get rid of all smoking.”

About 480,000 people die from smoking each year, Bates noted, which is a huge number compared to other public health issues. And, he added, “another 16 million live in misery” from smoking-related diseases. Because smoking rates are far higher among lower socio-economic groups, targeting it also adds to social justice efforts. “If you can do something about smoking, you can do something about health disparities, which is a good thing.”

Bates argued the U.S. could do something about it. But it is just choosing not to, as a matter of public health policy.

Since 2010, there have been alternatives to what public health pros call “combustible cigarettes,” new products that provide nicotine without combustion.

“If you get rid of the smoke, you get rid of almost all the toxicant exposure,” said Bates. “People will continue to use nicotine but at much, much lower risk.” Government authorities in Great Britain have pegged the health risk from e-cigarettes, vaping, and other similar products at about 95 percent lower than smoking.

But instead of encouraging smokers to switch to lower-risk alternatives, as the U.K. has done, the FDA has been funding major marketing efforts targeting vaping and e-cigarettes, convincing smokers there is no health benefit from making the change.

As a result, most Americans incorrectly believe vaping is as dangerous as smoking.

One problem, Bates said, is that the FDA doesn’t know how to regulate something that comes with some risk but is far safer than the alternative. He said that vaping isn’t food or medicine; it is more like beer or coffee. It’s something people consume because they enjoy it.

“They don’t really know what they’re doing with these (smoking replacement) products,” he said. It would be better to consider them like coffee or moderate alcohol consumption. It’s pleasurable. It’s fun… It’s a harm reduction strategy. For people to use the products, they have to be appealing. Regulators have problems with that.”

And no, Bates added, the “F” in “FDA” does not stand for “fun.”

Dr. Brian Miller is a fellow at the American Enterprise Institute and a doctor at Johns Hopkins University. He used his real-world experience to discuss the CDC’s failures in the fight against COVID-19.

“I worked on COVID wards, and normally during a pandemic, you go to the CDC for advice,” Miller said. “Well, you’re in the middle of a global pandemic, and people are confined to their homes. You look up the CDC guidance, and the webpage hasn’t been updated. Or they don’t know.”

A pandemic caused by a communicable disease is the CDC’s reason for existence, and yet it wasn’t ready when the real thing happened. Why?

“The CDC’s mission has drifted,” he said. The agency started focusing on “current events” and health issues like the environment or addressing issues like racism and gun violence. Those healthcare issues keep the agency in the headlines but have little to do with the CDC’s job.

“Having an organization that is trying to be all things to all people all the time means that it cannot perform its basic functions, as we discovered during the pandemic.”

For Miller, the first step is obvious. “We should be directing our dollars to policy levers that work,” Miller said. “We should think about directing the CDC’s resources to its core mission and then some of those other funds and staff (could go to other agencies),” he said.

Also, the public should have the right to comment on CDC’s regulations.

“Public opinion still matters,” he said. “And public input matters.”

From a press release

Elizabeth “Betsy” Walls, RN, the retired director of personal health for the Chester County Health Department whose efforts helped to establish the Public Health Emergency Preparedness (PHEP) Program and Medical Reserve Corps (MRC) in Chester County, has been honored with a much-deserved award from the Centers for Disease Control (CDC). Walls is recognized as Pennsylvania’s PHEP Trailblazer, in celebration of CDC’s 20th anniversary of the PHEP program and Walls’ decades-long service to public health.

Commenting on the well-deserved honor, Chester County Commissioners Marian Moskowitz, Josh Maxwell, and Michelle Kichline said, “Betsy has served as a dedicated public health professional for decades, and Chester County was privileged to have her as part of the Health Department leadership team for nearly 20 years. Clearly her passion to care and protect for our communities did not stop with ‘retirement’ and she continues to actively serve as a medical volunteer in both Chester and Delaware Counties.

“In particular, Betsy helped to lead Chester County’s Medical Reserve Corps actions throughout the pandemic, including immense support for Delaware County, and she continues to work as an MRC Volunteer for Chester, Delaware and Philadelphia Counties.”

Jeanne Franklin, Director of the Chester County Health Department, said, “The Chester County Health Department admires Betsy as a dedicated healthcare worker, volunteer, and a friend. The honor bestowed to her by CDC is much deserved and we are grateful to have had her as a team member for many years.

“Betsy earned the title of ‘rock star’ from our staff and she is a cherished part of the Health Department family.”

Walls is a graduate of the Presbyterian Hospital School of Nursing and Widener University Graduate School of Nursing and Business.  She went on to serve the Delaware County Memorial Hospital in Nursing, Nurse Administration and Nurse Education for over 30 years and Penn Medicine Chester County as a Nursing Supervisor for seven years. Included in her illustrious career is a decade of service as a Flight Nurse for the Pennsylvania Air National Guard. Cuba, Germany and Japan were just a few of the places Walls traveled to as a Flight Nurse.

Her commitment to public service continued through the Chester County Health Department, where she served as Director of Personal Health for 18 years.  During her time at the Health Department, Walls was intrinsic in creating Chester County’s Medical Countermeasures Program (formerly the Strategic National Stockpile program) which brought together partners throughout the county to dispense medical countermeasures to county residents, employees and visitors if needed.

She also helped to establish Chester County’s MRC and was part of the County’s health and emergency response for incidents including Hurricanes Floyd, Isabel and Sandy, the ice storm that crippled Chester County for days in 2014, and completed well over 600 hours of service during the COVID-19 pandemic.

When asked about her extensive career in nursing and public health, Walls said, “I loved everything I did during my time at the Health Department. There was nothing that I didn’t like, and I’ve loved every day in nursing.

“Every experience has been a positive for me. Every experience has been different,” she added, while highlighting the support and skills of her colleagues throughout her career.

“Above all else, Betsy recognized the importance of planning and training for any type of public health emergency, and she helped to lead countless trainings and exercises across the southeast Pennsylvania region,” said Franklin.

Walls has also held several notable leadership roles, previously serving as President of the Delaware County Nurse Association, Pennsylvania Nursing Association, and President of the Pennsylvania Nurses Foundation. Her assistance with the development and implementation of volunteer education operations has contributed greatly to Chester and Delaware counties’ vaccination efforts.

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Back to School PA PAC, an influential local parents’ rights group, has joined a national effort challenging the Biden administration to commit to keeping classrooms open in the fall, even if COVID-19 cases continue. It’s an attempt to force the Centers for Disease Control and other public health professionals to acknowledge the research showing the impact of closed classrooms was more damaging to children than the coronavirus.

The open letter was penned by a coalition of scientists, doctors and mental health professionals under the auspices of Urgency of Normal, a group that is concerned that COVID-19 mitigation measures are hurting rather than helping children.

The letter emphasizes that CDC’s COVID-19 guidelines for children do more harm than good and continue to cause significant disruption to children’s education and to working parents while providing no demonstrable public health benefit in limiting the spread.

“Currently, nearly all U.S. adults and children are protected by either vaccination or infection-acquired immunity, and the U.S. is seeing far lower hospitalization and mortality rates than in prior surges. CDC policies have serious unintended consequences–-such as school closures, increased school absences, forcing parents to miss work, and the expense and time of testing,” the group said in a press release.

“Our nation’s children suffered tremendous learning loss as a result of prolonged school closures and are battling a well-documented mental health crisis, and ongoing COVID-19 testing and isolation periods are causing additional harm,” the letter said.

Back to School PA supported school board candidates across the state in 2021 who believed schools should remain open. They endorsed more than 200 candidates and nearly 60 percent won their races. And their predecessor organization, Keeping Kids in School PAC, had a 98 percent success rate in the 2021 primary for the candidates it endorsed.

Beth Ann Rosica

“It’s a nonpartisan group of physicians and parent groups that are advocating to get back to normal for kids,” said Beth Ann Rosica, Back to School executive director. “A lot of these mandates that have been happening all over the country…So they put together a toolkit back in (the winter) to help schools and people who work with kids to put policies in place that would allow kids to experience a more normal childhood. And Back to School PA pushed that out to our parent groups. And I personally went to my own school board, trying to advocate for more normal policies for our kids.”

The letter asks the CDC and the White House to “enact policies that are more reasonable because, even though here in Pennsylvania most schools are unmasked, there are still issues impending,” said Rosica.

“Because we know that cases are going to go up again in the fall and many of the schools have policies that allow for masking up again at certain levels of transmission,” Rosica said.”

And certain school districts were requiring vaccinations for activities like participating in sports, she said.

The letter is “very much of our beliefs and philosophy,” said Rosica. “That parents should be making these decisions and not school districts or even necessarily public health officials. We think it’s a good message.”

“And it’s not political, even though some will say it is,” said Rosica. “These are liberal doctors, conservative doctors, all different kinds of community groups.”

“We have written this letter because the lives of children and their families continue to be disrupted by unnecessary COVID-19 testing, isolation, and vaccine requirements. With high levels of both vaccination and infection-acquired immunity, it is time to lift the COVID-19 mitigation measures that are preventing our children from unconditionally participating in school, camps, and sports,” said co-author Dr. Eliza Holland, a pediatric hospitalist in Charlottesville, Va.

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