Listening yesterday to an NPR local political talk program. Supposed to be moderate, middle of the road but is really more like moderate in the sense of being between slightly left and hard left.
In this instance, they were talking to a senior figure at the CDC, discussing the decline of respect for and trust in expertise. Specifically, the participants were discussing the prospects and possible roll-out for a Covid-19 vaccine.
I think Operation Warp Speed to be an interesting public-private effort and that it was probably necessary at the beginning of the pandemic. Clearly most our public sector institutions were highly ineffective at the beginning, particularly the FDA and the CDC but not omitting WHO.
While I applaud the governance innovation and its better reliance on the private sector, I also suspect that there is a better than even chance that this might turn out to be a massively wasteful failure. Our track record for vaccines in general is pretty abysmal. We have no vaccine for the most similar virus outbreaks of the past couple of decades. It is hard to see all the regulatory corners being cut having exactly the same safety reliability as in the past.
Either the past processes were unnecessarily demanding (which is possible) or the new vaccines will have greater risk probabilities (also possible). Or both.
You don't have to be a doctor or expert to know this. Just a good memory of the past twenty years or twenty minutes access to Google search engine.
Any novel health emergency is inherently uncertain. We will get some decisions wrong in terms of the actual progression of the disease (remember Zika) or the magnitude of the impact or the real mortality risks, or the proper course of treatment, or the required resources.
From my perspective, Operation Warp Speed was as much about public reassurance at a time when we did not realize how low the mortality would be for most ages of the population as it was about an actual cure. Maybe we will get a vaccine quickly and maybe it will be safe, but past experience suggests that outcome is a low probability.
The CDC muckety muck (and the talking political commentators) were lamenting the decline in respect for science and experts and sotto voce suggesting that science had become tainted by politics and particularly by the disrespect of the Orange Man. That was the first tell that we aren't talking about science.
Anti-vaxxers are historically bi-partisan and the left leaning anti-vaxxers are actually more prominent in the media. This is neither a new issue nor a singular party one.
The CDC guy did acknowledge that dealing with a new outbreak is always challenging and that it cannot be expected that they will get everything right. But neither he nor the other commenters addressed that the CDC did not get much right. Slow to respond, contradictory instructions, bureaucratic turf-guarding, absence of the supplies which were supposed to have been stockpiled, failure to adhere to its own outbreak planning protocols - all were factors to substantiate that the experts were not competent.
Especially when such problems were also manifest at FDA, WHO and others as well. And especially when there were (and are) inconsistencies between and among them. And especially when some of their actions were transparently self-serving. "Don't need to buy masks because they are not effective" was simply an excuse or lie to protect supplies for health services since the stockpiles of mask and PPE were not available as they should have been.
The CDC expert and the chattering class were lamenting why ordinary citizens might not be as trusting of the experts as the experts might desire while not acknowledging the very failures of the experts which contributed to that loss of trust.
CDC man also did not address some of the pre-Covid policy debates which had already given rise to declining public trust.
Specifically, many on the right objected to the CDC increasingly pursuing non-medical political agendas. Among the more objected to was the effort ten or twenty years ago by the CDC to treat guns as a public health issue. On the right this was seen as an end-run around Second Amendment civil rights and as a diversion of resources from the CDC's actual authorized objectives - infectious diseases. This ultimately resulted in Congressional legislation to stop the CDC from expanding its remit into the political arena of gun control.
Pre-Covid CDC had already done a good job of eroding trust in it as an institution. Then it failed in its primary mission of disease control at the beginning of Covid-19, underperforming at both the policy and operational level.
This also was not discussed in the ostensibly open and intelligent discussion.
Finally, there was a further tell from the CDC leader. After repeatedly arguing over the course of the program that ordinary citizens should trust the CDC, trust the experts, and follow the science and after repeatedly disclaiming that the CDC was pursuing any political agenda, CDC man once again tipped his hand.
Having made some reasonable claim or plea, he then alluded to Covid in the context of America as a racist country suffering from gross inequality.
That might be a persuasive argument to the hard left but for everyone else it is an indicator that the CDC leadership is 1) distinctly ideological, 2) distinctly not expert, and 3) distinctly not to be trusted.
You don't have to be right-wing to see how significant an own-goal this was. He had one primary job to do on the show which was to demonstrate that the CDC warranted being trusted as a science-driven, non-political institution. Instead, he reinforced the perception that CDC leadership is ideological, incompetent, not science-driven and not to be trusted.
If quality decision-making, scientific integrity, and institutional trustworthiness are important goals, as I believe they are, this was a disaster of an interview.
What kind of blinkers prevent these bureaucratic experts from seeing that they are undermining their own case in real time? I don't know, but it is striking.
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