Wednesday, March 02, 2022

The CDC Abandoned Public Health And Science A Long Time Ago

tabletmag  |  The main federal agency guiding America’s pandemic policy is the U.S. Centers for Disease Control, which sets widely adopted policies on masking, vaccination, distancing, and other mitigation efforts to slow the spread of COVID and ensure the virus is less morbid when it leads to infection. The CDC is, in part, a scientific agency—they use facts and principles of science to guide policy—but they are also fundamentally a political agency: The director is appointed by the president of the United States, and the CDC’s guidance often balances public health and welfare with other priorities of the executive branch.

Throughout this pandemic, the CDC has been a poor steward of that balance, pushing a series of scientific results that are severely deficient. This research is plagued with classic errors and biases, and does not support the press-released conclusions that often follow. In all cases, the papers are uniquely timed to further political goals and objectives; as such, these papers appear more as propaganda than as science. The CDC’s use of this technique has severely damaged their reputation and helped lead to a growing divide in trust in science by political party. Science now risks entering a death spiral in which it will increasingly fragment into subsidiary verticals of political parties. As a society, we cannot afford to allow this to occur. Impartial, honest appraisal is needed now more than ever, but it is unclear how we can achieve it.

Consider a final example: the CDC’s near-total dismissal of natural immunity. Many other countries consider recovery from prior infection as a vaccination equivalent or better, an assumption that makes both medical and intuitive sense, but the CDC has steadfastly maintained that everyone needs the same number of vaccinations whether they have recovered from a COVID infection or not. This view is countered by data showing that vaccinating people who have recovered from COVID results in more severe adverse events than vaccinating people who have not had COVID.

In order to bolster the claim that people who have recovered from COVID benefit from vaccination as much as those who never had it, the CDC published a fatally flawed Kentucky-based analysis. The August 2021 study compared people who had contracted COVID twice against those who had it just once, and concluded that those who had it once were more likely to have had vaccination. But the study could have easily missed people who had two documented cases of COVID but might have had severe underlying medical conditions—such as immunosuppression—that predisposed them to multiple bouts of infection in a short period. In addition, people who had COVID once and then got vaccinated might not have sought further testing, believing themselves invulnerable to the virus. The study did not adequately address these biases. Months later, the CDC published a stronger, cohort study showing clearly that natural immunity was more robust than vaccine-induced immunity in preventing future COVID hospitalizations, and moreover, that people who survived infection were massively protected whether vaccinated or not.

But to listen to Walensky tell it, none of these complications even exist. On Dec. 10, 2021, she told ABC News that the CDC had seen no adverse events among vaccine recipients, and denied seeing any cases of myocarditis among vaccinated kids between 5 and 11. On that same day, however, data from her own agency showed the CDC was aware of at least eight cases of myocarditis within that age group, making her statement demonstrably false.

So why does the supposedly impartial CDC push weak or flawed studies to support the administration’s pandemic policy goals? The cynical answer is that the agency is not in fact impartial (and thus not sufficiently scientific), but captured by the country’s national political system. That answer has become harder to avoid. This is a precarious situation, as it undermines trust in federal agencies and naturally leads to a trust vacuum, in which Americans feel forced to cast about in a confused search for alternative sources of information.

Once that trust is broken, it’s not easily regained. One way out would be to reduce the CDC’s role in deciding policy, even during a pandemic. Expecting the executive agency tasked with conducting the science itself to also help formulate national policy—which must balance both scientific and political concerns and preferences—has proven a failure, because the temptation to produce flawed or misleading analysis is simply too great. In order to firewall policymaking from science, perhaps scientific agency directors shouldn’t be political appointees at all.

Ultimately, science is not a political sport. It is a method to ascertain truth in a chaotic, uncertain universe. Science itself is transcendent, and will outlast our current challenges no matter what we choose to believe. But the more it becomes subordinate to politics—the more it becomes a slogan rather than a method of discovery and understanding—the more impoverished we all become. The next decade will be critical as we face an increasingly existential question: Is science autonomous and sacred, or a branch of politics? I hope we choose wisely, but I fear the die is already cast.

 

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