Last update: Tuesday 1/11/22
CDC blunders under President Biden
President Biden appointed a new Director of the CDC when he took office in January 2021, but the CDC continued to commit catastrophic blunders, four of which are doscissed below:
- "Impending doom"
At the end of March 2021, President Biden's newly appointed Director of the CDC made a public declaration of her sense of "impending doom"
-- "CDC director warns of 'impending doom' as Covid-19 cases spike in most states", Christina Maxouris and Holly Yan, CNN, 3/29/21
Her pessimism was stunning because it came two months into President Biden's full court press to vaccinate as many U.S. residents as possible, as quickly as possible. Therefore it came at a time when one would expect that our highly effective vaccines would soon begin to greatly impede the surge of coronavirus infections ... and it was stunning in retrospect because it was so blatantly wrong.
, - "Independence Day"
Indeed, our new vaccines soon crushed the new infection curves. They were so effective that a few weeks later, the CDC made a mind-boggling flip-flop by announcing that U.S. residents no longer needed to wear masks or maintain social distancing in most places
--"Vaccinated Americans May Go Without Masks in Most Places, Federal Officials Say", Roni Caryn Rabin, Apoorva Mandavilli and Noah Weiland, NY Times, 5/13/21
Over 700 epidemiologist made a public declaration of their assessment that this new guidance was imprudent
-- "723 Epidemiologists on When and How the U.S. Can Fully Return to Normal", Claire Cain Miller, Kevin Quealy and Margot Sanger-Katz, NY Times, 5/15/21
The imprudence of the CDC's no-more-mitigation guidance became undeniable a weeks later, when the resort community of Provincetown, Massachusetts recorded a mega cluster of over 900 new Delta infections, 700 of whom were completely vaccinated ... which forced the CDC to issue yet another flip-flop guidance that advised U.S. residents to go back to wearing masks again.
-- "Interim Public Health Recommendations for Fully Vaccinated People", Centers for Disease Control ... 7/28/21
--"‘It’s Nowhere Near Over’: A Beach Town’s Gust of Freedom, Then a U-turn", Ellen Barry and Beth Treffeisen, NY Times, 8/1/21
-- "How Provincetown, Mass., stress-tested the coronavirus vaccine with summer partying and delta", Hannah Knowles and Randy Dotinga, Washington Post, 8/5/21 - Underestimating Delta breakthroughs
The CDC should be an action-oriented research agency, but it isn't. It should provide timely short-range guidance in the context of mid to long range frameworks, but it doesn't.
In this case the CDC stopped monitoring breakthrough cases that were not severe enough to warrant hospitalization in May 2021, after the Delta variant appeared, but before Delta's most relevant properties had been identified. Lacking the data it needed to accurately estimate the number of asymptomatic and/or mild Delta infections, the CDC repeatedly claimed that breakthrough infections of fully vaccinated persons were rare.
-- "CDC under fire for decision to limit tracking of Covid-19 cases in vaccinated people", Rachel Roubei and David Lim, Politico, 7/30/21
The mass breakthroughs in Provincetown during the July 4th holiday weekend.nation's was the nation's wakeup call about Delta breakthroughs
-- "Outbreak of SARS-CoV-2 Infections, Including COVID-19 Vaccine Breakthrough Infections, Associated with Large Public Gatherings — Barnstable County, Massachusetts, July 2021", C.D.C., 7/30/21
Unfortunately for the CDC's credibility, Delta breakthrough cases were not rare; they were also highly contagious.
-- "The Delta Variant Isn't As Contagious As Chickenpox. But It's Still Highly Contagious", NPR, 8/11/21 - Failure to strongly recommend N95 masks
The limited supply of N95 masks in March 2020 was a plausible justification for the CDC's guidance that N95 masks be reserved for healthcare professionals and encouraging the rest of us to adopt cloth masks. However as anyone who passed an Econ 101 course would have predicted, the excess potential demand for N95 masks (and KN95 mask) eventually generated a substantial increase in their supply ... without any government intervention.
-- "How to Buy a Real N95 Mask Online", Brian X. Chen, NY Times, 2/17/21
-- "Why Are Millions Of N95 Masks Sitting In A Factory Without A Buyer?", Darian Woods, NPR, 4/7/21
By mid 2021 at the latest, enough N95 masks were available for everyone who wanted one, although the price of these non-reusable masks may have been too high for lower income groups. Nevertheless, had higher income groups adopted N95 masks, the spread of Delta and Omicron would have been greatly curtailed. Hundreds of thousands of lives would have been saved, including the lives of lower income cloth wearers who would no longer be infected by contact with infected members of higher income groups who wore N95 masks.
Bottom line: the CDC should have strongly recommended N95 (or K95) masks for everyone who could afford one, and recommend that President Biden provide free N95 masks to everyone in lower income groups, but it didn't. Instead it merely issued a tepid concession that N95 mask provided far greater protection than cloth masks.
-- "The C.D.C. conceded that cloth masks do not protect against the virus as effectively as other masks.", Apoorva Mandavilli, NY Times, 1/15/22
Then President Biden announced the distribution of 400 million N95 masks, not to the lower income groups who could not afford to buy them, but to "everyone" who asked for one. As we all know "everyone" will not wear masks, even if they are free. But it's reasonable to assume that most of the
200 million U.S. residents who have been fully vaccinated will wear them.
-- "White House to distribute 400 million free N95 masks starting next week", Lena H. Sun and Dan Diamond, Washington Post, 1/19/22
Each vaccinated resident will only receive 400 million masks / 200 million = 2 masks, not even enough for one week because N95 masks aren't supposed to be reused. Lower income recipients will soon have to go back to cloth masks that provide little or no protection against Omicron. Of course upper income groups will be able to buy whatever additional masks they need to protect themselves and their families throughout 2022 ... if they are encouraged to do so.
The CDC needs a Director who can turn it around
The whole is greater than the sum of its parts, but only if the parts are properly aligned. Only well organized agencies will be more productive than the sum of the efforts of their individual employees. The CDC supposedly employs leading experts in fields related to the prevention and control of infectious diseases. Therefore its many blunders throughout the pandemic provide undeniable evidence that its talented employees are not organized into effective teams. Indeed, other observers have cited the CDC's blunders to come to the same conclusion.
- "The CDC Waited 'Its Entire Existence for this Moment.' What Went Wrong", Eric Lipton, Abby Goodnough, Michael D. Shear, Megan Twohey, Apoorva Mandavilli, Sheri Fink and Mark Walker, NY Times, 6/3/20
- "Inside the Fall of the CDC", James Bandler, Patricia Callahan, Sebastian Rotella and Kirsten Berg, ProPublica, 10/15/20
- "COVID proved the CDC is broken. Can it be fixed?", Jeneen Interland, NY Times, 6/16/21
The CDC is mired in its founding culture, a culture that mandated that all of its guidance be derived from well established science. But for pandemics whose variants evolve much faster than scientific understanding, the CDC needs a culture that commits it to making timely, rational judgements that are informed by, but are not limited to a lagging science.
Changing an organization's culture is one of the most difficult management interventions. Top level managers whose interventions succeed are sometimes called "turnaround artists". The online Urban Dictionary offers two examples of successful turnarounds: Mitt Romney's transformation of the Salt Lake City Olympics in 2002 and Lee Iacocca's transformation of Chrysler in the 1970s and 1980s into profitable operations.
- "Turnaround artist", Urban Dictionary
Like many other "soft" skills, the capacity to transform dysfunctional organizations into successful ones is best demonstrated by a track record of having done it before. Just because the president of ABC University is a widely respected academic leader doesn't mean that he or she will be able to transform the dysfunctional XYZ University into a successful operation. But if ABC U. was dysfunctional before he or she became president, and successful afterwards, then he or she might also have what it takes to transform XYZ University. So too with complex government agencies like the CDC.
Below the reader will find a link to the bio page on the CDC's Website for its current director, Rochelle P. Walensky, MD, MPH, and a link to her Wikipedia page that provides a lot more information. As the reader will see, neither source cites any prior experience transforming dysfunctional organizations of any kind into successful ones. So why should anyone be surprised that she failed to transform the deeply dysfunctional CDC?
We must therefore expect that the CDC will continue to emit confusing guidance, no matter who its director is until President Biden subjects it to a thorough top-to-bottom reorganization under the leadership of a Director who has a track record as a successful transformer of complex government agencies.
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Related notes on this blog:
- "Avoiding the CDC's systemic blunders and flip flops", Last update: 1/7/22
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