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Trust In CDC And FDA Is At A Low


Public trust in the CDC and the FDA is at a low right at the moment when the agency's need to be increasing efforts to limit the spread of COVID-19 and building confidence in a future vaccine. One of the key problems - mixed messaging from the top of the administration and political interference by appointees and advisers who have little experience in public health all while faced with one of the greatest health and economic challenges we've seen. NPR's Selena Simmons-Duffin is here to walk us through some of the missteps and to answer the question, where do we go from here?

Selena, welcome to the program.


CORNISH: So where shall we start?

SIMMONS-DUFFIN: Let's start Feb. 25. So at the time, there was no reported community spread in the U.S., but it was starting to spread and Italy in Iran. And fears were starting to intensify that it was coming here. On that day Dr. Nancy Messonnier, the director of the National Center for Immunization and Respiratory Diseases at CDC, spoke to reporters, and she said this.


NANCY MESSONNIER: We are asking the American public to work with us to prepare in the expectation that this could be bad.

SIMMONS-DUFFIN: It was this striking moment, and it got people's attention.


MESSONNIER: I had a conversation with my family over breakfast this morning. And I told my children that while I didn't think that they were at risk right now, we as a family need to be preparing for significant disruption of our lives.

SIMMONS-DUFFIN: The Trump White House was not happy about this. There were reports that the president wanted her fired. He was upset about the stock market falling in response to these concerns. And there was a press briefing with health officials later the same day in which they tried to soften that message. And the next day President Trump put Vice President Pence in charge of the White House coronavirus task force. And from that moment, public briefings have largely been with elected officials and political appointees, not with career scientists.

CORNISH: So do people look at this as the first kind of clear moment where, like, politics is getting prioritized over science?

SIMMONS-DUFFIN: Yeah. It really seems that way in retrospect because we haven't heard a lot from career scientists since that moment. And there's also been kind of this battle over the CDC's coronavirus website. Officials are always telling the public that that's the best source of reliable information. But we now know that this Web resource, which is supposed to be clear and scientifically vetted, has had political interference. One of the first examples is when this happened.


GEORGE STEPHANOPOULOS: We do have another cautionary tale right now. It's about a choir practice in Washington state that took a tragic turn. You know, despite practicing social distancing, 45 people who showed up have now tested positive or are showing symptoms of coronavirus, and two members have died.

SIMMONS-DUFFIN: So this happened early in the pandemic, and there was a CDC write-up about it in the agency's flagship publication Morbidity and Mortality Weekly Report. But the guidance on the website flipped, so language about how indoor singing should be avoided was taken out. And when NPR asked CDC about it, we were told, quote, "CDC posted the wrong version of the guidance." The new guidance, we were told, quote, "is the version cleared by the White House."

And there was a more recent example about testing asymptomatic people who'd been in contact with a confirmed case. CDC quietly changed the website. Reporters noticed, and they had to backtrack. So it's really troubling since consistency is so important for public trust. And because with a totally new virus, sometimes the guidance changes because scientists learn something they didn't know before. So remember the early mask guidance?

CORNISH: I mean, there's been a lot, but yeah. Maybe you're - are you talking about the time that the surgeon general tweeted to stop buying masks?

SIMMONS-DUFFIN: Right. Exactly. So the tweet was, quote, "seriously, people, stop buying masks. They are not effective in preventing the general public from catching coronavirus." Now scientists believe people wearing masks in public is extremely important to curb the spread. So it's confusing. Sometimes guidance changes for legitimate reasons, and sometimes it seems it changes because of political interference. And it's really hard for the public to keep track of which is which.

CORNISH: Is this just about the CDC, or is it about politics and federal health agencies in general, right? People talked about the Food and Drug Administration and how it would approve a coronavirus vaccine. What's happening there?

SIMMONS-DUFFIN: Yes, that's right. It's definitely not just about CDC. When it comes to FDA, the concern is really about its role in approving a vaccine. And President Trump has made clear he wants a coronavirus vaccine as fast as possible. But trust is especially key with vaccines. They do absolutely nothing if people don't get immunized, and people won't get immunized if they don't trust the process.

So the FDA commissioner Stephen Hahn has pledged that science will drive the agency's decision-making. He and other public officials say that corners aren't being cut to speed up COVID-19 vaccine development. But in response to reports this week that the agency was toughening up some of its criteria, the president said in a press conference that it seemed like a, quote, "political move" to him.

CORNISH: And we should mention it was last week that President Trump essentially contradicted the head of CDC Robert Redfield, who testified on the Hill.


ROBERT REDFIELD: If you're asking me when is it going to be generally available to the American public so we can begin to take advantage of vaccine to get back to our regular life, I think we're probably looking at third - late second quarter, third quarter 2021.

CORNISH: And then the president said this.


PRESIDENT DONALD TRUMP: I don't think he means that. I don't think he - when he said it, I believe he was confused. I'm just telling you we're ready to go as soon as the vaccine happens.

SIMMONS-DUFFIN: So this makes everyone else confused. When the top officials in the government are saying the opposite things, the public has to decide who to believe. And consistency is really fundamental to public trust.

CORNISH: Let's talk more about how to restore public trust. What's necessary to make that happen? How can that happen?

SIMMONS-DUFFIN: Well, I think that generally, what public health agencies do and what the WHO has been doing all through this pandemic is to just have regular conversations, regular briefings so that the public knows what's happening and has that background. So I think it goes back to that briefing with the CDC scientist we talked about at the very beginning of this conversation. The American public needs to hear directly from CDC scientists regularly without a political filter. And when guidance changes, it can't be done quietly. There needs to be acknowledgement that a change is happening and a justification for why.

CORNISH: That's NPR's Selena Simmons-Duffin. Thank you.


(SOUNDBITE OF BIG STAR SONG, "THE BALLAD OF EL GOODO") Transcript provided by NPR, Copyright NPR.

Selena Simmons-Duffin reports on health policy for NPR.