Trump pressure on health agencies risks undermining public confidence

The Trump administration’s moves to put pressure on scientific bodies to take controversial steps against the coronavirus threaten to undermine public confidence in health experts at a time when they have become uniquely visible.

On Sunday, the Food and Drug Administration (FDA) issued a permit for emergency use of restorative plasma as a treatment for COVID-19. Scientific studies are not conclusive about taking that approach, and some have said that authorizing its use will hinder the ability to conduct more definitive research.

And on Monday, the Centers for Disease Control and Prevention (CDC) quietly changed its guidance on testing those in contact with a COVID-19 patient. The agency no longer recommends testing those contacts, despite what is known about the risk of asymptomatic and pre-symptomatic spread of the virus.

Both decisions appear to have appeared through politics: A new treatment, announced by President TrumpDonald John The memo: Trump reaches for optimism as weapon against Biden Five cuts to GOP’s groundbreaking convention Trump mocks Democrats in White House speech: ‘We are here and they are not’ MORE on the eve of the Republican National Convention, has been presented as proof that the nation is on the verge of a miraculous recovery. At the same time, guidance may suggest that fewer people being screened is likely to lead to lowercase letters, even if the virus is spreading widely.

And in both cases, the scientists leading the agencies later acknowledged the concerns raised by their actions. FDA Commissioner Stephen Hahn criticizes his decision to use emergency plasma recoveryfully justified, ”While CDC Director Robert Redfield on Thursday clarify the new guidance against testing contacts.

But initial decisions leave some in the public health community saying the damage has already been done.

“The recent episodes at FDA and CDC are prime examples of how you should deal with, or undermine public health confidence,” said Rich Besser, a former acting director of the CDC who now heads the Robert Wood Johnson Foundation. “When you look at public health advocacy that has been extremely influenced by politics, it underscores the confidence that is so essential.”

Trump has despised government experts and government officials, repeatedly questioning protectionist intent intended to curb infections, from reopening the economy to the use of face masks. That doubt has sown rejection of basic adherence to public health advocacy – and even skepticism that the virus is real – sewn under Trump’s base and in conservative media.

“The government needs to work together to protect the entire country, and instead we are seeing this open disagreement that will further sow public discord and undermine public confidence,” said Howard Koh, an assistant secretary of health in the Obama administration. now teaches at Harvard’s Chan School of Public Health.

The risk in politicizing science and health, experts said, is that a distrustful public will be less willing to accept the next recommendation – or even a vaccine. Polling shows that a significant percentage of Americans do not want to get a vaccine once an effective candidate emerges; that number would grow if the public had reason to question whether a vaccine was being hunted in the market before the appropriate security checks were completed.

“If there are concerns that the process by which the FDA decides to make a vaccine good is influenced by policy, it will diminish public confidence in that vaccine,” Besser said. “It will probably lead to fewer people wanting to get that vaccine.”

Vaccines are most effective when they are administered to a wider section of the population, and a pathogen denies the vectors it needs to spread and survive. The higher the proportion of the population receiving a vaccine, the lower the risk of spread – even among those who choose not to vaccinate themselves.

Anthony FauciAnthony Fauci Shifting CDC Test Guidance Thinks Backward American Medical Association Criticizes New Trump Test Guidance The Hill’s Morning Report – Presented by Facebook – Pence Shuts Biden as Radical Risk MORE, director of the National Institute of Allergy and Infectious Diseases, warned this week against an emergency permit for a vaccine before testing shows that it is both safe and effective.

Koh said the U.S. stands for a mom or make-or-break.

“This is a time to insist that the rigor and science of the decision-making process be kept at the highest level. The future of global public health depends on it, ‘he said.

History is full of examples of a distrustful public that does not adhere to health guidelines, to its own detriment.

Polio vaccination campaigns in Afghanistan and Pakistan have been interrupted by rumors that vaccinators are secret intelligence agents. Ebola outbreaks in the Democratic Republic of Congo and West Africa dragged on for years amid conspiracy theories that the virus had plotted to eliminate one tribe or another.

“Trust is a two-way street between communities and individuals who need to take advice on things in which they have no expertise, and for reasons beyond their own interest,” said Prabhjot Singh, a globalist health expert at the Icahn School of Medicine and Mount Sinai Health System. “These are moments when people are starting to reverse their involvement, and that hurts trust in communities, it hurts the country and it hurts individuals. Taking it all back together takes a lot of deep work. ”

Public health experts have seen with growing apprehension how the Trump administration has sidelined scientists, and especially the CDC. In previous health crises, CDC directors have served as the public face of the government’s response, in a way that Redfield does not today.

“One of the most powerful tools that CDC has is the ability to communicate,” Besser said. “In this pandemic, she was taken away.”