Five years ago, on a late Monday evening in March, Gov. Brian Kemp and his top health aides hastily called a news conference at the Capitol to make an announcement that would touch every person in Georgia.
The Atlanta-based Centers for Disease Control and Prevention had just confirmed Georgia’s first cases of the new and mysterious disease — COVID-19.
That first case in Georgia was found on March 2, 2020, in two Fulton County residents who had just returned from a region in Italy where infections were surging.
Today, that announcement was the initial blip that ended in more than 2 million confirmed cases and more than 38,000 deaths across the state.
While the disease continues — the CDC says 164 Georgians died of COVID-related causes in the most recent three-month period — it’s not the menacing, invisible threat that existed when shutdowns, quarantines, protests, mask mandates and pandemic panic ruled for months on end.
But the CDC is again in the hot seat, and in an even more serious way for the agency itself.
Some experts who’ve spent their careers in public health are concerned that trust in the agency has eroded, and it is one of several government institutions being targeted by the new Trump administration. All of that, experts fear, could make the next health crisis far worse.
In the last month, hundreds of CDC employees have been abruptly fired or quit as President Donald Trump takes aim at federal spending and what he calls waste.
The CDC’s data and communication are under skeptical review. Staff have been told not to communicate with outside partners such as the World Health Organization without high-level permission, hamstringing their work. Meetings to decide on next year’s flu vaccine have been canceled altogether. Morale has tanked.
All this is happening as bird flu begins to move from cows and poultry to humans. An outbreak of measles has just killed an unvaccinated child in Texas.
“I’m saddened and concerned,” said Dr. Anne Schuchat, a retired CDC official who served as principal deputy director in Trump’s first term. “The thing about the government, before even considering the CDC, is it’s for everybody.”
While companies, universities and faith-based groups can do a lot, she said, “the gaps between what those institutions are doing are very important.”
“Having a national strategy, having the coordination of all the states, can be really lifesaving for fast moving threats like the pandemic,” Schuchat said.
Credit: Pablo Martinez Monsivais
Credit: Pablo Martinez Monsivais
The seemingly random cuts and lack of information about what’s happening to workers inside the agency are causing concern and confusion at a crucial time, said John Besser, a former deputy chief at the CDC who is an expert in foodborne and waterborne diseases.
“Those of us who have worked there are pretty sure that it’s cutting in some important places,” Besser said. “But we have no way of knowing.
“If you’ve been watching the measles reports that have been coming in, the experts that TV stations, news media have been pulling in haven’t been from CDC, even though the most knowledgeable people in the world on measles are at CDC.”
Politicization and distrust
During the height of the COVID-19 pandemic, the CDC became a lightning rod for politicized divisions over masking, vaccines, distancing, shutdowns, remote learning and science. And it made mistakes.
Those lab results transmitted to Kemp’s aides five years ago were the starting gun that kick-started the local public health contact tracers and public warning.
But the system didn’t work perfectly.
Georgia’s state lab should have been doing that test on its own. But it couldn’t, because the CDC had taken up time developing its own test, separate from the one widely in use internationally. And when the CDC’s test kits arrived at public health departments across the country, they were flawed.
There were other lags and stumbles, such as the CDC initially not recommending blanket use of face masks.
However, day in and day out, the CDC staff fought the war of the pandemic. They researched the virus, devised tactics and tools to outmaneuver it, and brought those to states and communities. They pulled together resources and flagged dangers.
While the virus killed more than 1 million Americans and isolation took a lasting toll, vaccines and countermeasures also saved millions of lives. That’s partly because of the work done by CDC employees in offices, labs and the field.
Dr. Hugo Scornik, a pediatrician in Conyers and leader at the state chapter of the American Academy of Pediatrics, said he is dismayed at the level of distrust with the CDC.
Scornik said he hears about the distrust on the news, and every once in a while, increasingly so, a patient will refuse vaccinations that could save their child’s life.
“Of course, I wish everything was perfect,” Scornik said. “I wish the CDC test was out rapidly. I do think it made a big difference, that we didn’t have a lot of testing initially. (But) I’m also very happy about the way some things went,” including development of the vaccine.
Dr. Michael Mina has fierce criticisms of the CDC, starting from his early years doing research there.
Mina, a former associate professor at the Harvard School of Public Health, is so passionate about the need to move faster and follow the science regardless of political blowback that he left Harvard to join a private biotech company to push verifiable at-home testing and treatment for COVID-19.
If huge numbers of people were frequently tested, he said, that could provide protection when people aren’t vaccinated.
Mina believes CDC’s culture is too academic and not good at the social science of communicating with regular people. He sees the disruption right now and hopes it can be leveraged toward reform.
However, he calls the administration’s approach “devastating” to the agency’s ability to execute.
“If you want to change the priorities of the CDC, I am 100% behind that, like … I do believe that we need to be focused more on chronic care,” he said.
But, indiscriminate slashing of the agency “is completely crushing morale,” he said. “And that might sound froofy. But the fact is, if your government employees don’t have morale, then why the heck are they going to work hard for the American people?”
Pleasing the public won’t be easy. The criticisms about CDC come from both sides: Those who think the agency should step back, and those who think it should be more active.
Some public health critics who thought CDC moved too slowly on COVID-19 make a similar case now, with avian flu. They say the CDC and other federal agencies should have been testing more farm animals much sooner, before the bird flu virus gets the chance to mutate into something that can spread easily between people.
That criticism runs the risk of letting people forget what the agency accomplishes, said Scornik.
Scornik thinks some of the loss of trust in the CDC is beyond the agency’s control and is happening to branches of government and institutions across the board. He says it takes time for people to become comfortable with a new vaccine.
“And in my experience, it takes a couple of years,” he said. “But during COVID, we didn’t have a couple of years.”
No one knows whether another pandemic is imminent, but others will come eventually, say experts like Besser. And while some experts are saying now is a terrible time to throw the CDC’s workforce into chaos — in the face of bird flu, measles and other outbreaks — that misses the point. A robust CDC workforce is always crucial to national safety, he said.
“It’s like looking for meteors that might strike Earth,” said Besser. “You really can’t stop looking for them.”
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