The CDC, staffed with 20,000 people, has long served as a model for public health agencies around the world, with a global stature in the hands of few agencies in the United States.
But even before the pandemic, Trump administration health officials had discussed narrowing the scope of the CDC, emphasizing Redfield after his arrival in 2018 that he should consider reorganizing and refocusing the public health agency.
CDC had taken on a growing range of research projects and areas of study in recent years, they argued, a constant expansion that ran the risk of distracting itself from its core mission as the country’s primary authority to identify and respond to disease threats. infectious. Subsequently, the CDC published a strategic framework that defined the agency’s “five core capabilities”.
In Trump’s proposed budget for fiscal year 2021, the administration proposed a cut of approximately 19 percent to the agency’s discretionary budget. This year’s budget plan also proposed to refocus CDC on “its primary mission to prevent and control infectious diseases and other emerging health problems, such as opioids.”
The coronavirus crisis, and major errors by the CDC, have only strengthened the case for a review, said a former senior official who participated in those discussions.
“What you need to do is look closely at the CDC and say what are the five things they really need to do, and do it to the exclusion of everything else,” the former official said, adding that Redfield had agreed with the Pre-pandemic concerns that the agency’s activities were too scattered. “People have been talking about the basics, the main mission.”
Redfield’s work is not in jeopardy with such a close election, but officials from across the White House orbit have focused on the CDC as a major issue within the coronavirus response. The vice president’s office has raised concerns about the accuracy of the death toll from coronavirus, while parts of the Office of Administration and Budget, such as the United States Digital Service, have participated in the review of data at the state level.
As the country’s leading public health authority, CDC has traditionally played a central role in shaping the federal government’s response to health crises and communicating with the public. But the agency took a much lower profile amid the pandemic, after a series of mistakes that sparked anger from White House officials and hampered the administration’s early response efforts.
Initial tests for coronaviruses developed by the CDC in February turned out to be flawed, delaying widespread plans to detect the virus and allowing it to spread across the country for weeks. An internal HHS investigation published last week found that the faulty test kits were likely contaminated at the CDC.
Messages from CDC officials at the start of the crisis, while in line with assessments by the scientific community, have embarrassed White House officials trying to contain the political consequences.
Nancy Messonnier, a top CDC authority, surprised the White House in late February when she told reporters that a coronavirus outbreak was inevitable, contradicting claims by top officials at the time the disease it was largely contained.
In April, Redfield caught Trump’s attention after warning that the country could face a brutal second wave of the disease in the fall, a statement he was forced to clarify the next day.
And more recently, the agency has come under scrutiny from the White House about guidelines to reopen schools and institutions that were initially deemed too prescriptive, and from public health experts for combining two different types of coronavirus tests in its overall numbers of tests.
An administration official said the main problem with CDC has been with data it receives from states on the number of deaths from Covid-19, creating a bigger problem that clouds the U.S. response.
“In Pennsylvania, if you have coronavirus and you die from a gunshot wound, it is classified as a coronavirus death,” said the administration official. “If data drives decision making, you need to make sure you have good data. When you have different ways of counting things, it can cause distortions. The audit was suggested as a means of confirming or refuting that. “