Public Health Has Done More With Less, but This Is Ridiculous
It’s going to be an interesting four years, to say the least.
Well, it’s happening. I learned today from a friend who works at the Centers for Disease Control and Prevention (CDC) that CDC will not be putting out any communications until further notice. The party officials are not yet in place to start reviewing everything CDC puts out to the world. So no more Morbidity and Mortality Weekly Report, health alerts, or anything like that “until further notice.”
I didn’t want to believe it at first, but The Washington Post later confirmed what my friend said:
“The instructions were delivered Tuesday to staff at agencies inside the Department of Health and Human Services, including officials at the Food and Drug Administration, the Centers for Disease Control and Prevention and National Institutes of Health, one day after the new administration took office, according to the people with knowledge, who spoke on the condition of anonymity to describe private conversations. Some people familiar with the matter acknowledged that they expected some review during a presidential transition but said they were confused by the pause’s scope and indeterminate length.
The health agencies are charged with making decisions that touch the lives of every American and are the source of crucial information to health-care providers and organizations across the country.
The pause on communications includes scientific reports issued by the CDC, known as the Morbidity and Mortality Weekly Report; advisories sent out to clinicians on CDC’s health alert network about public health incidents; data updates to the CDC website; and public health data releases from the National Center for Health Statistics, which tracks myriad health trends, including drug overdose deaths.”
Great.
You would think that I would be freaking out, or be “triggered” like the fascist followers of the current administration would like us scientists and public health workers to be. But I’m not. Strong reactions to these things don’t help. So I found myself going back to the lessons of my grandfather and his work in the opposition during the perfect dictatorship in Mexico.
The first thing to remember is that we are not alone. The United States is a federation of 50 states and several territories. And, in the United States, public health is mostly the purview of the state and local governments. Sure, it would be nice to have the resources and coordination from CDC, but we’re going to be okay if we can’t rely on them for a while.
Some states will have to pick up the slack. Big city health departments will have to take the lead in their regions. New York City in the northeast, with support from Boston, Philadelphia, and Washington, DC. Minnesota in the Midwest, with support from Chicago, Omaha, and Kansas City. Los Angeles in the Southwest, with support from San Francisco, Las Vegas, Phoenix, El Paso, Denver, and maybe Salt Lake City. The states of Oregon and Washington will have to pick up the slack in the Pacific Northwest, and maybe lend a hand to Idaho and Montana.
And the South? I’ve got no clue. Maybe New Orleans with help from Tulane can look after that region. But the state governments in that region of the country are so anti-science that it wouldn’t surprise me if one of those states outlawed science. True story. Good luck, Southeners.
Then again, North Carolina has been training public health workers through UNC. There might be hope for the South yet.
And, yes, I know I previously said CDC needed a reboot, but I didn’t expect it to come to a complete halt in its work of informing the public on present and coming public health threats. Instead, I wanted it to be apolitical, non-partisan, and neutral. I wanted party officials out of it, letting the scientists do their work and communicate freely. But it’s not any of those things. CDC is effectively now a tool of whoever is in the White House.
God help us.
The most worrying part of it all is not the lack of information. The part that will keep me up at night for the next few weeks is what fills that void. Whenever this happens, online grifters and snake oil salesmen step in to make a quick buck and spread their disinformation. And they don’t care who they hurt, because it’s mostly those who are unable to speak for themselves who get hurt. The very young, the very old, and the very weak.
Of course, some of us will attempt to fill the void with factual information. Some of us hold ourselves up to a higher standard. We’ve taken an oath, and we are serious about it. I’ll be right here, writing. I’ll be out there, doing my epidemiology work and teaching. And I’ll be the best father I can be in teaching my kid to know the difference between valuable information and snake oil.
Your mileage may vary.
Good luck.
If you like what I wrote, buy me a coffee? https://ko-fi.com/epiren
René F. Najera, MPH, DrPH, is a doctor of public health, an epidemiologist, amateur photographer, running/cycling/swimming enthusiast, husband, father, and “all-around great guy.” You can find him working as the director of a center for public health, grabbing tacos at your local taquería, teaching at a university in northern Virginia where he is an adjunct in the Department of Global and Community Health, or teaching at the best school of public health in the world where he is an associate in the Department of Epidemiology. All opinions in this blog post are those of Dr. Najera, and do not necessarily represent the opinions of his employers, friends, family, or acquaintances.
