Can We Ever Trust Our Public Health Officials Again?
By Marisa Herman
Healthcare institutions who’ve historically enjoyed a high level of public trust may soon face a steep erosion of the American people’s confidence after more than a year in the spotlight for a coronavirus pandemic that was fraught with bungled predictions, fumbled responses, and numerous examples of hypocritical leaders.
Healthcare institutions who’ve historically enjoyed a high level of public trust may soon face a steep erosion of the American people’s confidence after more than a year in the spotlight for a coronavirus pandemic that was fraught with bungled predictions, fumbled responses, and numerous examples of hypocritical leaders.
From mandates for testing, mask wearing, and businesses openings, the doctors leading federal health agencies became the face of the government line, with Americans turning to their advice to stay safe as the country grappled with combating an unprecedented pandemic.
But as the coronavirus began to spread, infecting millions and killing more than 570,000 Americans to date, trust in directives issued by the leader of the Centers for Disease Control and Prevention, the director of the U.S. National Institute of Allergy and Infectious Diseases Dr. Anthony Fauci, and officials with Health and Human Services rapidly diminished as they spewed confusing and often contradictory guidelines that dealt with opening or closing schools and businesses, testing, mask wearing, and even what activities are now safe for those who’ve been vaccinated by a trio of miracle drugs.
Their repeated failures have many public health experts questioning if the country can reestablish trust in its public health system before the next crisis strikes.
“It’s not just about this pandemic, it’s about the next one,” said biopharmaceutical expert Dr. Jeremy Levin, chairman of the global association the Biotechnology Innovation Organization.
Betsy McCaughey, chair of the committee to reduce infection deaths, said the CDC has become “totally ineffective.”
“The CDC has become a laughing stock and the butt of jokes on late night TV,” she said, derisively referring to it as the “centers for double talk and confusion.” McCaughey slammed officials who she said seemed to issue guidelines based in “everything except science.”
Sally Pipes, president, CEO, and Thomas W. Smith Fellow in health care policy at the Pacific Research Institute, said the inconsistent messaging has left the American public unsure of who to trust.
“People aren’t sure who to believe,” she said. “You see people driving around in L.A. in cars by themselves wearing a mask. It’s just ridiculous.”
While hiccups in the early days of the pandemic were expected as the country faced an unknown and deadly pathogen, inconsistencies and backtracking continued to plague health agencies months into the crisis, as they frequently recommended a specific course of action – only to change it days later.
Fauci, who became the front man for the country’s coronavirus response, has flip-flopped and contradicted himself numerous times over the past year, all while becoming something of a celebrity by appearing on magazine covers and throwing out first pitches – while Americans have footed the bill for his whopping $417,608 annual salary, according to 2019 records.
The highest paid employee in the federal government, initially directed Americans to continue their everyday lives before advocating plunging the country into total lockdown. When it came to wearing masks, he told people they were unnecessary. Then, he told people not to leave the house without one and later doubled down on wearing a mask, literally, calling two masks greater than one.
Critics say public health messaging is being obscured by politics — with Fauci often cast as a foil to former President Donald Trump by his many media detractors — and the CDC has come under fire for its mixed messaging, as well.
Levin said the “intrusion of politics into science and medicine” contributed to the country’s bungled response efforts in the early months of the pandemic.
“When you face a public crisis, public trust depends on the complete integrity of the facts given to you and given to you by scientific and medical experts,” he said.
The confusion, however, hasn’t subsided when it comes to guiding Americans on what is and isn’t safe more than a year into the pandemic.
In a March 29th interview with MSNBC, CDC director Dr. Rochelle Walensky suggested that “vaccinated people do not carry the virus.” Her assertion was walked back by the CDC days later after many researchers slammed her comments, saying it was too soon to know the effect the vaccine has on transmission.
After the agency eased up on travel guidance for people who are vaccinated, Walensky contradicted her own agency’s advice and said she would “advocate against general travel overall.”
“CDC messaging on restrictions post vax has been a mess,” Dr. Vinay Prasad, an associate professor of epidemiology and biostatistics at the University of California, San Francisco, tweeted earlier this month.
McCaughey scoffed at a CDC recommendation to open windows in classrooms in order to curb the spread of the virus.
“That could have been written in 1950 or even 1900,” she said. “They have totally overlooked and failed to evaluate the existing and emerging technologies that can shield us from the next virus or pathogen that could plague the nation.
“We now have tech that can be installed in the lighting or HVAC system to automatically destroy viruses in surfaces and in the air. Telling a school in New York City to open a window, it’s crazy.”
Doug Badger, a visiting fellow in domestic policy studies at The Heritage Foundation, said the CDC is “often behind the science” in its guidelines because it has had to spend a lot of energy pushing back on disinformation and is reluctant to admit its own “unforced errors.”
“To the extent [the CDC’s] credibility erodes, the credibility of disinformation rises,” Badger said.
Levin notes the CDC has a “very difficult task” of navigating through a “raging pandemic” all while new information emerges as they battle it.
“It’s very difficult in the fog of war to get something 100% right,” he said.
The CDC’s faltering guidance has directly impacted Americans’ overall trust in federal health agencies. Public polling indicates confidence in federal health agencies like the CDC has plummeted amid the pandemic.
According to a study released in April, which was conducted by researchers at the RAND Corporation, a nonprofit research institute, public trust in the agency fell about 10% between May 2020 and October 2020 alone.
“The Biden administration will have an uphill battle in rehabilitating trust in the CDC at this critical junction in the coronavirus pandemic,” Michael Pollard, lead author of the study and a senior social scientist at RAND, said in a statement about the findings. “A key challenge in the months ahead will be to identify who will be viewed as trusted messengers regarding vaccines and public health policies.”
Lois Davis, co-author of the report and senior policy researcher at RAND wrote that “public suspicions of scientific experts and distrust of government institutions are increasing for a variety of reasons. Reasons for this include a blurring of the line between opinion and fact, and access to more sources of conflicting information.”
A similar poll conducted by the nonpartisan Kaiser Family Foundation had results that mirrored the RAND poll.
According to the Kaiser survey, which was conducted from Aug. 28 to Sept. 3, public confidence in the CDC dropped 16 points since April. During the same time frame, trust in Fauci specifically decreased 10%.
McCaughey called the public’s trust in health agencies like the CDC “foolishly high” before the pandemic.
“The CDC has failed on several accounts before this, but no one really noticed because the stakes were much lower,” she said.
In order to restore faith in the public health system, McCaughey said the CDC needs a total overhaul.
“The White House should take dramatic steps to clear house at the CDC and provide real scientific leadership,” she said.
Sally Pipes, however, said whoever heads up any government agency will likely be influenced by politics. She pointed out that Fauci, Walesnky, and others appeared to “change their position on things like mask wearing and social distancing” to respond to political pressure.
“People who are public servants are worried about their own careers and they have a cautious nature,” she said.
In order to regain public trust in public health agencies, Levin said three things must occur: First, politicians need to stop talking and let medical officials guide the way. Second, messaging from the leading health officials must be transparent, coordinated, and consistent. Third, the media has to understand that the enemy is the virus or pathogen and not a political party.
Before moving ahead, Badger said there must be an “honest look back” at actions taken by the CDC and other federal health agencies to really understand why they were made.
While it may not paint these agencies in the best light, he said institutions make mistakes and those mistakes should be analyzed.
“Sometimes we compound those mistakes by not owning up to them,” Badger said.
But even if they learn lessons from this pandemic, McCaughey said the public should remain concerned about putting its trust in government-led health agencies: “Even more than the confusion and delays and ineffectiveness in the past, their biggest failure has been to prepare us for the next pandemic.”
