WASHINGTON — The CDC needs to be improved, members of Congress seem to agree, but at a House hearing Wednesday there didn’t seem to be much agreement between Republicans and Democrats about the best way to do it.
“One of my biggest frustrations with the CDC is that when you look at all the talent, all the scientific knowledge, technical resources, and immense funding that we have put into the agency, the end product is somehow less than the sum of its parts,” Rep. Morgan Griffith (R-Va.), chair of the House Energy & Commerce Oversight and Investigations Subcommittee, said at a hearing entitled “Looking Back Before Moving Forward: Assessing CDC’s Failures in Fulfilling its Mission.”
Admitting There’s a Problem
“It is reasonable for the American people to expect CDC to use the best available science when preparing guidance and recommendations,” Griffith said. However, “all too often during the pandemic, the CDC appeared to work backwards. The agency seemed to first decide its preferred policy outcome, whether that was universal masking, vaccine mandates, shutting down businesses, or school closures. Once the policy was decided, then the agency sought out data supporting that policy decision.”
Griffith praised the agency for conducting an internal review of its performance during the pandemic. “The first step is admitting you have a problem,” he said. “This review has now led to a reorganization that appears on its face to be extensive, but there’s no way for us to tell without more information from the CDC.”
Rep. Frank Pallone Jr. (D-N.J.), ranking member of the full Energy & Commerce Committee, blasted what he saw as the hearing’s premise. “Let’s call this hearing what it is: an opportunity for committee Republicans to criticize the work of the Centers for Disease Control and Prevention during the COVID-19 pandemic without them being here,” he said. “While I appreciate the [other] witnesses for being here and look forward to their testimony, if Republicans were really interested in conducting oversight of the CDC, they would have invited the CDC to be here today.”
Pallone added that although the pandemic presented a big challenge for the entire federal government when it first appeared in 2020, then-President Trump’s actions in particular were not helpful. “We all remember him repeatedly casting doubt about the dangers of COVID-19 right from the start,” Pallone said. “In January 2020, Trump said that it was ‘One person coming in from China and we have it under control. It’s going to be just fine.’ … At the end of February 2020, he said the cases would ‘be down to close to zero and then one day, it’s like a miracle; it will all disappear.’ He publicly promoted hydroxychloroquine as a treatment.”
Griffith said the committee would have the CDC director testify “in due time, but they need to answer our written requests for documents and information with something other than just a thin, cursory statement … before we bring them in for a detailed oversight hearing. We’re going to go forward and get the information that we can today and then we will bring in the CDC; they will have the stage all by themselves to explain it to us.”
Suggestions for Improvement
Witnesses at Wednesday’s hearing had a variety of views of how to improve the agency. Mary Denigan-Macauley, PhD, director of public health at the Government Accountability Office (GAO), said that “in April, we reported that CDC intends to undergo programmatic scientific and operational improvements to better support the agency’s public health response during emergencies and in peacetime.” The GAO, she continued, “met with CDC to get more information about the reform efforts and share the GAO’s leading practices for successful agency reform.”
“CDC says that it needs to share science and data faster. It needs to translate science into practical policy. It needs to prioritize communications for the American public. It needs to develop a workforce ready to respond to future threats and it needs to promote partnerships,” said Denigan-Macauley. “But CDC has not detailed answers to the questions I posed for how it will carry out these reforms.”
Georges Benjamin, MD, executive director of the American Public Health Association, had his own wish list, noting that the CDC needs data.
“Public health is fundamentally a data-driven science,” he said. “Without data, we can’t make data-driven decisions, but we need to end the practice of being ‘data archaeologists.’ We need a health information technology system. The fact is that I can get food right now on my phone … but I can’t get my EKG. We need to fix that. And we need to strengthen the public health workforce.”
Charity Dean, MD, MPH, founder of the Public Health Company, called for a better intelligence and operational infrastructure. “Containment of biological threats … is not possible without these twin capabilities,” she said.
Dean recalled that when she served as a public health official and faced a meningococcal outbreak at a local college, “I implemented a range of broad temporary measures all at once — canceled parties [and] sports, gave antibiotics … By contrast, the CDC wanted to implement one mitigation measure at a time, like a controlled academic study. At the end of one long conference call with them, I was told I was alone in my decisions.”
The outbreak was contained, and “a few years later, CDC guidance was published with our approach as a model,” Dean said. “I want to emphasize my belief that the United States is still capable of solving hard problems. Solutions will require innovation, courage, and bold leadership.”
Politicization Accusations
Committee members accused their counterparts on the other side of the aisle of politicizing the issue. “I’m extremely disappointed that [Pallone] and others on this committee have decided to make this hearing political, about the former president, about scoring political points, not about serious reforms,” said Rep. Cathy McMorris Rodgers (R-Wash.), chair of the full Energy & Commerce Committee. “You want to look at bad decisions — the number one mistake was blindly following [former White House Coronavirus Task Force member] Dr. [Anthony] Fauci, who was so focused on COVID-19 that he refused to think about every other aspect of public health, to the detriment of our children, our economy, and our country.”
On the Democratic side, Rep. Raul Ruiz, MD (D-Calif.), said, “There’s a lot of emphasis in trying to prove some intentional and nefarious scheme from Dr. Fauci and [former NIH director] Dr. Francis Collins, that somehow suppressed information that the virus was created in a lab and leaked from a lab, and now there’s some kind of web of cover-ups, [even] with multiple statements from our public health leaders that that is not true.”
“We’re missing the opportunity to focus on things that will actually prevent a pandemic and help us prepare for a pandemic,” he said. “I’m hoping that we can move from this partisan narrative to more concrete solutions.”