CDC. The test instructions were published against the objections of the scientists
A heavily criticized recommendation from the Centers for Disease Control and Prevention last month as to who should be tested for the coronavirus was made by C.D.C. not written. Scientist and was posted on the agency's website despite serious objections, including several people familiar with the matter and internal New York Times documents.
The instructions said there was no need to test people without symptoms of Covid-19 even if they were exposed to the virus. It came at a time when public health experts were pushing for more testing than less, and Times administrators told the document the document was a C.D.C. Product and was developed with the help of the director of the agency, Dr. Robert Redfield, revised.
But officials told The Times this week that the Department of Health and Human Services did the rewrite and then posted it on the C.D.C. "dropped" which violates the agency's strict scientific review process.
"That was a top-down document from the H.H.S. and the task force, "said a federal official, aware of the matter, referring to the White House task force on coronavirus. “This policy does not reflect how many people at the C.D.C. Politics should be feeling. "
The document contains "elementary errors" – such as B. "Testing for Covid-19" as opposed to testing for the virus that causes it – and recommendations that are inconsistent with the CDC's stance and that would label it as non-conforming to anyone in the know According to a senior CDC written by scientists from the agency Scientist who spoke on condition of anonymity for fear of repercussions.
Adm. Brett Giroir, administration testing coordinator and assistant secretary for the Department of Health and Human Services, the CDC's parent organization, said in an interview Thursday that the original draft came from the CDC, but that he “coordinated the editing and input from the scientific and scientific community medical members of the task force. "
Over a period of a month, he said, the draft went through about 20 versions with comments from Dr. Redfield; Top White House Task Force Dr. Anthony Fauci and Dr. Deborah Birx; and Dr. Scott Atlas, President Trump's advisor on coronavirus. Members also presented the document to Vice President Mike Pence, who heads the task force, Admiral Giroir said.
He said he didn't know why the recommendation made the usual C.D.C. scientific review. "I think you must be Dr. Ask Redfield about it. That was certainly not my direction, ”he said.
The C.D.C. On Thursday evening, Dr. Redfield sent an email stating, “The guidelines, which were coordinated in collaboration with the White House coronavirus task force, have been properly followed, consulted and supported by experts on the task force.
The question of the independence and effectiveness of the C.D.C. As the country's top health department, urgency has grown as the country nears 200,000 deaths from the coronavirus pandemic and Mr Trump continues to criticize his scientists and ignore their assessments.
A new version of the testing guidelines, expected to be released on Friday, has also not been cleared through the CDC's usual internal review of scientific documents and is being revised by health and social care officials, a federal official who was not empowered to do so told reporters to talk about the matter.
Similarly, a document advocating "the importance of reopening schools" was included in the C.D.C. Website of the Department of Health and Human Services in July and is presented in the usual neutral and scientific tone of the C.D.C.
The information comes just days after revelations made by political officials at H.H.S. mingled with the acclaimed weekly reports of the C.D.C. about scientific research.
"The idea that someone at H.H.S. would write guidelines and place them under the C.D.C. The banner is absolutely cool, ”said Dr. Richard Besser, who was Deputy Director at the Centers for Disease Control in 2009.
Dr. Thomas R. Frieden, director of the agency during the Obama administration, said, “H.H.S. and the White House, which made scientifically imprecise statements such as "Do not test all contacts" on the C.D.C. writes is like someone destroying a national monument with graffiti. "
The vast majority of C.D.C. Documents are still meticulously prepared and reviewed and valuable to the public, but politically motivated messages mixed with public health recommendations undermine the institution, said Dr. Peace. "The graffiti makes the whole monument look pretty bad," he said.
The current guidelines for testing, published Aug. 24, state that people with no symptoms "don't necessarily need a test" even if they've been in close contact with an infected person for more than 15 minutes. Public health experts criticized the C.D.C. for this stance it would undermine efforts to contain the virus.
"The suggestion that asymptomatic people don't need testing is just a recipe for spreading through the community, as well as other diseases and deaths," said Dr. Susan Bailey, president of the American Medical Association, who normally works closely with the C.D.C.
Some experts also said that the recommendation appeared to be politically motivated to make the number of confirmed cases appear smaller than it is.
Dr. Redfield later tried to go back on the recommendation, saying testing could "be considered for any close contact," but his attempts only added to the confusion. The language on the C.D.C. remained unchanged.
The Infectious Diseases Society of America, usually a close partner of the C.D.C., strongly criticized the recommendation to test. "We have this with the C.D.C. and H.H.S., but I haven't seen any signs that they will change it," said Amanda Jezek, senior vice president of the organization.
At a congressional hearing on Wednesday, Dr. Redfield, the agency is revising the recommendation and will publish the revision: "I hope before the end of the week." The revision was done by a C.D.C. Scientist, but was being worked on Thursday by the Department of Health and Human Services and the White House's coronavirus task force, according to a federal official familiar with the matter.
Dr. Redfield also said at the hearing on Wednesday that vaccines would not be widely used until next year and that face coverings would be more effective than vaccines – claims Mr Trump sharply criticized in a press conference Wednesday night, saying Dr. Redfield had "a mistake."
The director was from C.D.C. Employees and outsiders as weak and ineffective executives who the agency cannot protect from the administration's interference in its science or from the increasing public distrust of the agency.
"It feels like a setup," said the C.D.C. Scientists added that many academics within the agency believe that it is to blame for the government's unpopular policies.
"CDC. Scientists are scared," said Scott Becker, executive director of the Association of Public Health Laboratories. "There's nothing they can do to get them out of this guilt game."
The Centers for Disease Control and Prevention were also often criticized during the pandemic for being too slow and cautious in making recommendations on how to deal with the coronavirus. This is in part because every document is deleted by at least one person on several relevant teams within the agency to ensure that the information is kept with the “current status of C.D.C. Data as well as other scientific literature, ”said a senior scientist of the agency, who spoke on condition of anonymity.
In total, each document can be approved by 12 to 20 people within the agency. "As someone who reads them regularly and as someone who has written things with C.D.C., I can tell you that the sharing process is painful but useful," said Carlos del Rio, an infectious disease expert at Emory University. "It's very detailed and very careful, and frankly, they improve the documents."
According to official information, at least eight versions of the current test guidelines were distributed within the agency in early August. The scientists' objections to the document went unheard. A senior C.D.C. According to an email from The Times, the official told the scientists, "We are unable to make significant changes." The test instructions were then tacitly published on the agency's website on August 24th.
Following the publication of the new guidelines, media inquiries to the agency regarding their content were directed to the Ministry of Health and Human Services, leading to speculation about their origin. CDC. Scientists were asked to ensure that other pages on the site followed the new recommendations. In a “Topics to Talk” memo distributed around the agency on September 1, employees were instructed to say that the C.D.C. participated in the development of the new guidelines, "with proposed comments and changes communicated to HHS and the White House Task Force".
This type of instruction would not have been necessary if the C.D.C. according to experts who are familiar with the agency's procedures. "I've never seen this topic of conversation before," said a C.D.C. Scientist said.
The Recommendation also asked people who "attended a public or private gathering of more than 10 people (without widespread masking or physical distancing)" to get tested only if they were "vulnerable" . In fact, the agency recommends people gathering in such groups, and its scientists avoid using the term “at risk” to describe risk groups, according to a C.D.C. Scientists familiar with the agency's procedures.
The guide is also nested in the section dedicated to health care workers and laboratories, but is aimed at the general public and makes multiple references to “your health care provider”.
"We just looked so sloppy," said the scientist. "This is killing me, it didn't come from within."
Experts who work closely with the C.D.C. said the mistakes were obvious.
"You are used to reading Shakespeare and all of a sudden you are reading a tabloid," said Dr. del Rio. “There was political pressure on C.D.C. in the past, but I think this is unprecedented. "
Sharon LaFraniere and Michael D. Shear contributed to the coverage.
