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The C.D.C. Waited ‘Its Entire Existence for This Moment.’ What Went Wrong?

2020-06-03 16:19:00

The C.D.C. is where they expect to get answers. As the national clearinghouse for critical public health information, it has dual missions: to provide medical guidance to health workers while offering easy-to-understand information for political leaders, business executives and the general public.

But many say the agency has struggled at times to provide clear and timely guidance.

At Margaret Mary Community Hospital in rural Batesville, Ind., doctors and nurses got sick after following C.D.C. guidance in mid-March that masks were necessary only when treating patients with respiratory symptoms or fever. The first patients who tested positive for Covid-19 there instead showed up with headaches, fatigue, nausea and diarrhea.

“This virus made it halfway around the world without us having a heads-up to our providers that this is how the disease can present,” said Tim Putnam, the hospital’s chief executive. “Over two months after the disease surfaced, I would have expected better.”

Front-line doctors and nurses have long relied on the agency for advice on clinical best practices, and many said in interviews that they were satisfied with the C.D.C.’s advisories, especially given the novelty of the coronavirus.

The agency has issued 114 advisory documents for disaster and homeless shelters, retirement communities, taxis, pediatric clinics and other venues. “We have issued countless guidance and recommendations based on the best available science and data,” an agency press officer said. Its experts have also held about a dozen calls for clinicians about caring for Covid patients, and other calls for medical groups.

But in interviews with medical practitioners across the country, many said they now look elsewhere for detailed recommendations about how to safely care for infected patients, posing questions about the new virus on mailing lists or scouring online research articles.

In a crisis, one of the C.D.C.’s main roles is to explain its guidance and reasoning, provide a rationale for when its thinking changes and acknowledge what it does not know. The agency’s routine in past emergencies was to hold press briefings almost daily; Dr. Thomas Frieden, Dr. Redfield’s predecessor, was highly visible during the Ebola and Zika crises. But in this case, medical workers and the public were left to make sense of often-opaque postings on the C.D.C.’s website after ​its leadership stopped holding regular briefings on March 9.


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