The CDC Needs to Stop Confusing the Public
nytimes.com
nytimes.com
The CDC has become untrustworthy because they have allowed/been forced to let politics override science.
It doesn't help that there are propaganda institutions shouting louder than the scientists, either.
I don't have an answer here, just an observation of the problem.
If your goal is to eradicate a virus, science tells you the correct policy choice is to ban all interpersonal interaction for several months, stop all transportation, and put locks on everybody's doors so they can't leave their houses.
But then everybody starves to death. And anything less won't actually eradicate the virus, as we've seen.
Policy makers need to balance the countable mathematical goals with the uncountable moral and political goals, and Hume's Guillotine tells us there is no calculus that can tell you the right balance.
If we did something like this or what China did in the first place, it would've died out.
Relying on individual responsibility inexorably leads to a Tragedy of the Commons. Individuals can never be trusted.
Those are ideals, and they aren't always compatible, available, or attainable.
0: some examples; some of these are NYT https://taibbi.substack.com/p/aaugh-a-brief-list-of-official...
The moment the CDC came into the national spotlight in March 2020, that was it for their bipartisan reputation as a trustworthy agency.
Part of public trust is believing in good faith decision making, which implies that mistakes are seen positively or neutrally in hindsight - part of the process of learning, not evidence of corruption or gross ineptitude.
When is the last time a major US policy mistake didn't result in a political field day?
The CDC never stood a chance, if we're being honest.
If 9/11 happened in the current world (under trump OR biden), the political circus, division, and paranoia would be immense.
* most every fire department * many public school systems * as far as federal agencies, transportation, NASA, NSF, Medicare, to varying extents.
I'll grant you medicare. I don't think transportation, NASA, or NSF are really something people really care about (in the emergent "should I wear a mask when I go outside" kind of care), but maybe I'm wrong on those.
China is not North Korea. There is a large foreign presence in China. Wuhan is a large city (between Moscow and Seoul in population) with many foreigners present there for business. The US, the UK, France, and South Korea maintain diplomatic offices in Wuhan.
That's a lot of non-Chinese observers who could see first hand what is happening in Wuhan and report back to their home countries.
It's just not possible for a country as large and divided as the US to have the CDC take a "forceful, quick, clear and unified response" she wants them too.
Let other departments spin the message. If the CDC doesn't stick to science and facts they'll undermine their own authority (which to a large degree they've already done).
Droplet transmission is currently thought to be the leading mechanism of Covid-19 transmission and masks have been shown to reduce the quantity of droplets expelled and inhaled. Definitive data is not available on how effective masks are on reducing transmission of Covid-19 specifically."
What not to say might include "If you are NOT sick: You do not need to wear a facemask" followed by an about-face a few months later. It's well-established that the CDC knowingly provided bad advice about the need for masks in spring 2020 to avoid a run on masks: https://web.archive.org/web/20200329005833/https://www.cdc.g...
Someone in a position of medical authority knowingly giving harmful advice is incredibly damaging and unethical.
"As of [todays date], the CDC does not recommend the use of masks in indoor spaces by people without Covid-19 symptoms.
Droplet transmission is currently thought to be the leading mechanism of Covid-19 transmission and masks have been shown to reduce the quantity of droplets expelled and inhaled. Definitive data is not available on how effective masks are on reducing transmission of Covid-19 specifically.
Despite the possible benefit, the CDC recommends reserving masks for the sick, healthcare workers, and high risk groups while the current shortage of available N95 masks is in effect."
The point is to provide accurate information. Lying might have short-term benefits in manipulating behavior, but destroys trust. If the run on masks is still a problem, the solution should have been more government involvement in the the supply chain and distribution of the masks.
New data or corrected mistakes change information and a significant portion of the public does not appear to handle that well.
See: the information on the effectiveness of cloth masks, the information on pathogen particle size and transmission distance, and terminology used.
And IIRC, in the last administration, large swaths of the country had no trust in anything they did. For example, the current VP said she would not take a vaccine developed under the previous administration.
Ultimately, CDC knows that the country is incredibly divided politically and should adjust its message accordingly. That was true for the previous admin, and it's true for this one.
[0] https://www.yahoo.com/entertainment/kamala-harris-says-she-w...
[1] https://www.cnn.com/2020/09/05/politics/kamala-harris-not-tr...
> Susan Page (Debate moderator):
> No, no, you’re Senator Harris to me. For life to get back to normal, Dr. Anthony Fauci and other experts say that most of the people who can be vaccinated need to be vaccinated. But half of Americans now say they wouldn’t take a vaccine if it was released now. If the Trump administration approves a vaccine before or after the election, should Americans take it, and would you take it?
> Kamala Harris:
> If the public health professionals, if Dr. Fauci, if the doctors tell us that we should take it, I’ll be the first in line to take it, absolutely. But if Donald Trump tells us that we should take it, I’m not taking it.
https://www.cnn.com/2020/09/05/politics/kamala-harris-not-tr...
Seems extremely reasonable to me - I wouldn't trust Kamala Harris' word alone on the efficacy of a vaccine either, I'd trust the science!
Trump is not the fda. Trump was never going to 'approve' a vaccine without fda. This sort of fear mongering is responsible for a lot of vaccine hesitancy
It is clear from the data on who is getting vaccinated that folks who voted trump tend to be less likely to be vaccinated. I doubt they're hesitant because of Vice President Kamala Harris' reasonable words.
Take Alabama, a state with the lowest vaccination rates. In Alabama, blacks and whites are on different sides of the political aisle, yet their vaccination rates are.... The same.
Income, profession, location and education correlate better with vaccination rates than anything..
In general democrats are wealthier than republicans so it is no surprise that they have higher vaccination rates.
Even amongst dems, if you look at the poorer factions which are mainly their nom white factions, vax rates are similarly low.
https://taibbi.substack.com/p/vaccine-success-media-misery-i...
https://www.kff.org/policy-watch/the-red-blue-divide-in-covi...
My suspicion is this stems from trump's poor handling of COVID and downplaying the threat of the virus from the beginning, Vox goes into more detail:
https://www.vox.com/2021/7/6/22554198/political-polarization...
Based on polling, conservatives are less likely to even consider vaccination: "while Republicans, rural residents, and White Evangelical Christians continue to be disproportionately more likely to say they will definitely not get vaccinated." - https://www.kff.org/coronavirus-covid-19/poll-finding/kff-co...
Thankfully the trend might be changing, folks like Steve Scalise who initially declined the vaccine received the shot and is now advocating for it, but we don't know if this has helped convince conservatives to vaccinate yet as he only did this in July:
https://www.washingtonpost.com/outlook/2021/08/02/republican...
This shift among conservative leaders and media has only happened in the last month or so, The Atlantic did a piece on this:
https://www.theatlantic.com/ideas/archive/2021/07/fox-news-c...
> In general democrats are wealthier than republicans so it is no surprise that they have higher vaccination rates.
The vaccine is free. The correlation on vaccination rates to how counties voted is a much stronger relationship than income.
The data lines up with my anecdotal experience as well. The folks I know who are antivax and taking hydroxychloroquine are extremely conservative. When they've talked about their viewpoints they point to Fox and trump as trusted sources on the topic.
You could make an argument that college education plays a large role in whether or not folks are antivax, those numbers closely align with party identification though so I'm not sure that's useful:
"There remains a large gap in vaccine uptake across education, with about eight in ten college graduates (79%) saying they have gotten at least one dose of the COVID-19 vaccine, compared to about six in ten adults without a degree who say the same (59%)" - https://kff.org/coronavirus-covid-19/poll-finding/kff-covid-...
While my friends in places like SF had to wait months to get a shot, I walked into a grocery store and got one without any waiting. The maskless women who gave it to me was surprised I was there because I was the only person under 70 she had seen come in.
The original claim was that large swaths of the public don't believe the virus exists.
That is ridiculous.
If the claim was large swaths of the public believe it to be as dangerous as the flu, then that's different and changes the meaning.
And with regards to the age group you're referring, the under 70s. For young people, covid really is no more dangerous than the flu.
I know you're unlikely to take advice from an internet stranger, but I do hope you get vaccinated and reconsider your position.
What I am not is a fear mongerer. The data show that if you're young and without preexisting conditions your chances of survival without hospitalization are excellent.
I'm sorry you've lost friends, but just because I've also lost friends to mild diseases, like the common cold or common bacteria, doesn't mean I need to tell people who don't think a cold is a big deal that they're a cold denier.
That's anti science nonsense
So it’s not unusual that in a rural area…folks may not see Covid as the threat that others do. I viewed it as a threat enough to get vaccinated as soon as I was able, but out of an abundance of caution…not fear.
The only person I know who died lives in a third world country and had medical issues. Terribly sad, but I mean we hear stories of all kinds of terrible disease from there.
Knowing something is real, but not being affected or concerned about it is a lot different then claiming it doesn’t exist.
Her critiques of the CDC generally aren't dependent on a public that trusts the government. Yeah, a lot of people will reject the CDC's guidance even if it's good, but there are plenty of people who want to follow CDC guidance, and they struggle to understand it, and when they do follow it, it leads them to stupid decisions because the CDC's advice isn't consistently reasonable.
If you're interested in responsible and intelligent COVID-related analysis, she's the one to follow on Twitter: https://twitter.com/zeynep
Perhaps it’s the other way around? As in the large part of country lost their faith in public health administration and in general institutions because of their mixed and conflicting message and in some cases playing ideologies?
What we see as "the CDC" is largely the product of people at the NYT and other news outlets. The CDC site has far more information than any of us want to read, and when the NYT "summarizes" their words to say something different, the CDC still get the blame.
The leadership of the CDC is helping destroy the labor of all those good people too; Redfield (was it? the director) telling Congress last march that "they had everything they needed to control this disease" was one of the finest displays of burro-crat stupidity in the history of the nation.
At a minimum, the leadership is just completely inadequate to deal with this type of problem. My feeling is that the situation is similar to the U.S. Army at the beginning of WWII. The U.S. kept losing battles at the very beginning until large parts of the top leadership that were good at paperwork and bureaucracy but bad at leadership in the field were replaced with leaders that were good at winning battles.
In the same way, the CDC leadership appears to be optimized for a slow pace, and the avoidance of mistakes that they can be blamed for. What we needed was a "wartime CDC" that could make quick, correct decisions based on incomplete data, and use their capacity to go out and acquire more information as it was needed.
"thats the job." isnt a magic incantation at the end of the day its your best effort. the best the little guy does right is what counts. I once had to supervise a shop floor where a worker amputated three fingers in a machine. i stayed to file paperwork, stayed with the gal while the EMT's arrived, coordinated the next shifts, worked nonstop trying to keep things going with blood on my work slacks and after a sixteen hour day I still didnt feel like i did anything but fail. I poured over safety trainings, studied the machine, and remembered all the safety meetings i gave but that still wasnt enough.
My foreman told me mottos are for boards and suits. at the end of the day the motto is only as good as the action. what did you do, and how well did you do it? If you walk away complaining then you didnt learn anything and nothing will change. if you have things to work on, things to improve and if you take criticism then yeah, you can say you are living up to the motto and striving to meet it every day. ours was "safety is job 1."
I think the CDC tried and did a pretty good job, but what i really want to see is what the CDC and others learn.
For example Taiwan didn't pretend masks or travel bans are ineffective.
Reminder that this is what the official narrative looked like in feburary-march 2020:
https://twitter.com/UNGeneva/status/1244661916535930886 https://twitter.com/who/status/1243972193169616898 https://i.imgur.com/lGXf03w.jpg
Sure, public institutions can be wrong and should be allowed to course-correct, but some of this wasn't due to uncertainty but deception, perhaps well-intentioned but still a political decision and not a communication of facts. And once this comes to light (as it did) people will remember it and it'll undermine the credibility of their future decisions.
When this extraneous considerations like this are considered, decision will be below-par
I sure hope we actually learn from this pandemic rather than being content to blame social media and anti-vaxers for all our problems.
I think that if a government agency is enabling the very people they claim to oppose, they've messed up.
Vaccine sceptics are the ones who are swayed by this, and are much more logical people. They're the ones who read the information and are still unsure. I can't fault them for making an informed decision, but it's difficult when there's so much conflicting information in such a short amount of time.
You are starting from the premise that you are correct, and that any evidence against your stance is a problem because it gives the people you have up-front decided are wrong more evidence.
Wouldn't a rational person say "here's some new information, maybe I should incorporate it into my views?"
Which is to say:
1) I read carefully, evaluate the methodology, assume authors are spinning for "high-impact" research, and believe results only once they've been replicated a few times by independent researchers using different methodologies.
2) I use results I haven't vetted like this in a probabilistic way -- they're often good for best practices, or identifying risks, but not as sources of ground truth.
What about the vaccine companies talking about booster shots to improve immunity? If it was already good enough why would anyone need more shots?
What about the amount of breakthrough cases that are happening? Covering those things up or not talking about them is misguiding and lying to the public.
Only when we get unbiased information can trust start to be regained.
They are doing the best they can in an incredibly difficult time and correcting course when necessary. Grow up.
https://en.wikipedia.org/wiki/List_of_epidemics
It's not entirely new, is it?
They have failed miserably both at controlling the spread of the disease and informing the public.
Instead of focusing on what they should be doing they are playing the politics and the CYA game. Disgusting.
1) You can state your recommendations and present the supporting data, assumptions, and unknowns.
2) You can state your recommendations as unquestionable facts, ignore contradictory data, and admit no uncertainty.
Reasonable people can understand that recommendations will shift over time. That said, to be a credible and respected source of information, you can't lie or overstate your case for maximum impact.
https://www.nytimes.com/2021/08/04/opinion/cdc-covid-guideli...
Yes, the CDC has stumbled multiple times and when you do that during a public health crisis it destroys confidence, but delivering a scientific message in an environment where new data is constantly streaming in is very hard.
Their job is not to be decisive, it is to inform, and an incomplete message repeated is inferior to an explanation including what is not known for certain, and just how uncertain it is and why.
Many, many opportunities for the CDC to educate have been squandered on preaching to the choir.
Edit: Though maybe you omitted a necessary "/s" sarcasm tag in favor of scare quotes.
I’ve noticed HN seems to entirely ignore the human aspect. Doctors understand it.
Tell all your type 2 diabetes patients if they dont take their medicine they’ll lose their legs. And guess what? 20% will lose their legs.
People aren’t robots. People are emotional. People aren’t always logical. People do the opposite. Why? Just because.
That’s the hand you’re dealt. Find a solution.
In this case, they've done the opposite - withheld the "scientific" message - on multiple occasions. The latest being about vaccinated people being able to spread the virus. That's not hard - that's straight up malicious.
Maybe the CDC could've gotten ahead of this by reporting clearly and honestly about the actual situation, but I wouldn't count on responsible reporting just because the information was responsibly handed out to journalists / the publications who desperately need people to click on their headlines.
[0] https://www.mediaite.com/news/nbc-news-ny-times-washington-p...