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CDC sources say White House putting politics ahead of science

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But about a week passed before the alert was issued publicly — crucial time lost when about 66,000 European travelers were streaming into American airports every day.

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The delay, detailed in documents obtained by CNN, is the latest example to emerge of a growing sense of disconnect between the CDC and the White House.
In interviews with CNN, CDC officials say their agency’s efforts to mount a coordinated response to the Covid-19 pandemic have been hamstrung by a White House whose decisions are driven by politics rather than science.
The result has worsened the effects of the crisis, sources inside the CDC say, relegating the 73-year-old agency that has traditionally led the nation’s response to infectious disease to a supporting role.
President Donald Trump speaks next to US Health and Human Service Secretary Alex Azar and CDC Director Robert Redfield during a tour of the Centers for Disease Control and Prevention on March 6, 2020. President Donald Trump speaks next to US Health and Human Service Secretary Alex Azar and CDC Director Robert Redfield during a tour of the Centers for Disease Control and Prevention on March 6, 2020.
Rising tensions between CDC leadership and the White House over the perception that the agency has been sidelined has been a developing story in the media for weeks. But now, mid- and higher-ranking staff members within the agency — six of whom spoke with CNN for this story — are starting to voice their discontent. Those six spoke on condition of anonymity for fear of reprisals.
“We’ve been muzzled,” said a current CDC official. “What’s tough is that if we would have acted earlier on what we knew and recommended, we would have saved lives and money.”

Where the relationship started to sour

Sources say the origin of the trust issues between the CDC and White House traces back to the CDC’s botched effort to distribute testing in early February, when contamination in the lab led to long delays. Relations between them soured further in late February, when high-ranking CDC official Nancy Messonnier warned the American public — at a time when President Donald Trump was out of the country and downplaying the threat — that “the disruption to everyday life might be severe.”
The consequences have filtered down to the American public in tangible ways.
Trump's Cabinet backs up his use of unproven drugTrump's Cabinet backs up his use of unproven drug
One that caused consternation within the agency involved the delayed travel alert in early March.
As Covid-19 was racing across the globe, a March 2 CDC internal daily report attributed spread in the European region to Italy but also noted “evidence of local transmission in 29 other countries.” In a follow-up report two days later, “85 international locations” had reported cases.
On March 5 — with three of the top six countries outside of China affected by the disease in Europe — the CDC was expecting to post a global travel alert that night, according to a CDC document that noted the alert had been cleared internally.
A general view of the Centers for Disease Control and Prevention Edward R. Roybal campus in Atlanta.A general view of the Centers for Disease Control and Prevention Edward R. Roybal campus in Atlanta.
Although the CDC had already posted some travel warnings for individual countries, such as China, Italy, Iran and South Korea, the proposed alert would have urged precautions for international travel anywhere.
But it didn’t happen that night. For unexplained reasons, the travel alert that was expected to be posted March 5 didn’t occur until March 11 — the same day Trump announced his sharp restrictions on travel from more than two dozen European countries.
Asked about the time lapse, a Trump administration official said the CDC had issued warnings and alerts by early March for specific countries dealing with outbreaks.
The administration official also said the CDC is one of many agencies that is a part of the White House Coronavirus Task Force, and that the views of CDC have always been represented at task force meetings and folded into what has been presented at White House press briefings on the virus.
CDC did not respond to multiple requests for comment on the travel advisory issue, or the wider allegation that the CDC has been sidelined.

White House was focused on China instead of Europe, source says

A senior official inside the CDC told CNN that the agency also alerted the White House to the virus’s rapid spread across Europe, but that “the White House was extremely focused on China and not wanting to anger Europe … even though that’s where most of our cases were originally coming from.”
Some experts say the worst consequence of the frayed relationship is a general sense that the CDC has lost its place as the face and voice of public health in the midst of a 100-year pandemic.
Why overcoming Covid-19 is just the first hurdle of a much longer journeyWhy overcoming Covid-19 is just the first hurdle of a much longer journey
“The CDC … were part of the mistakes with the early problems with testing, and it seemed like after that, they weren’t trusted as much,” said James Curran, dean of the Rollins School of Public Health at Emory University and a former CDC official. But, he added, “there’s no place in the world that has more epidemiologists and scientists studying respiratory infections. … We need them now.”
During the swine flu pandemic in 2009, Dr. Anne Schuchat — then the CDC’s director of the National Center of Immunization and Respiratory Diseases (she’s now the principal deputy director) — was a constant presence in the media, so much so that she became the inspiration for Kate Winslet’s character in the movie “Contagion.”
During the Ebola crisis of 2014, then CDC head Tom Frieden took command of the public spotlight, heading up press conferences to deliver the latest news and often serving as the voice of the federal government’s response in media interviews.
Centers for Disease Control and Prevention Director Dr. Robert Redfield, left, and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, depart after accompanying President Donald Trump at an April 16 press briefing.Centers for Disease Control and Prevention Director Dr. Robert Redfield, left, and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, depart after accompanying President Donald Trump at an April 16 press briefing.
Although the current CDC leader, Dr. Robert Redfield, participates in the White House briefings, experts say his presence has been subdued in comparison to his predecessors. The public face of the Covid-19 crisis has instead been ceded to Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, and Dr. Deborah Birx, coordinator for the President’s coronavirus task force.
“I respect and admire Dr. Fauci immensely but he represents the scientific and research lane, and Dr. Birx represents the policy lane at the White House level,” said Dr. Howard Markel, a public health and medicine historian at the University of Michigan. “The CDC represents the public health lane, internationally as well as working with state and territorial health offices, so I would want a representative from that lane.”

Trump administration has sidelined the CDC in coronavirus response, sources say

In the initial days of the outbreak in China, the CDC was out in front on public messaging.
It hosted a tele-conference call with reporters about the new coronavirus on January 17, not even a week after China had reported its first death.
WHO approves call for inquiry into global coronavirus responseWHO approves call for inquiry into global coronavirus response
“This is a serious situation,” said Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases. “It’s crucial to be proactive and prepared.”
But then came Messonnier’s grim warning on February 25. The following day, Trump installed Vice President Mike Pence as head of the White House Coronavirus Task Force.
Within a couple of weeks, the telebriefings tapered off.
“Then it got really dicey because obviously it became hyper political,” said a current CDC staffer.
Earlier this month, CNN reported that the Trump administration shelved CDC-drafted guidelines to reopen the US; the CDC’s guidelines were more strict and detailed than the White House’s own road map toward a return to normal.
“If you look at our guidance documents online, they have been watered down a lot,” said a current CDC official. “The ones that were written in March say, ‘Go home and stay there,’ and they are very clear. And the ones now say, ‘in consultation with state and local governors, do what they say.'”
The official added: “We normally give guidance and then states take that guidance and turn it into policy.”
A CDC employee said an overarching concern is that the agency’s scientific work is taking a back seat to politics.
“The message we received in previous administrations was, you guys are the scientists,” the employee said. “That’s not the case this time. If the science that we are offering up contradicts a specific policy goal, then we are the problem.”

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The politics of public health: U of T offers novel course in diplomacy for public health professionals – News@UofT

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Diplomacy is both art and science – and public health professionals increasingly need to understand each aspect in order to create positive change in the world.

That’s the guiding principle behind Canada’s first course in global health diplomacy at the University of Toronto’s Dalla Lana School of Public Health.

“There’s a lot of competition for ideas on the geopolitical stage,” says course co-founder and Associate Professor Erica Di Ruggiero, director of the Centre for Global Health. “How do you get an idea on the agenda so that it sticks? There are some very overt strategies to negotiate, persuade or influence. But the course is also about having a better understanding of the different players and their roles, and how to reach them.”

The Executive Course on Global Health Diplomacy is the newly minted centre’s signature offering – part of Dalla Lana’s expansion into the global health sphere. It will be offered online in partnership with the Office of International Affairs for the Health Portfolio (Government of Canada) and the Graduate Institute of Geneva from November 2020 to May 2021, and in-person June 7 to June 9, 2021. It’s aimed at mid-career public health professionals who want to influence policy at the World Health Organization and other major world bodies. But its architects also hope to attract diplomats-in-training with an interest in health policy.

“If you look at the Canadian approach, you either have people with technical knowledge of health or you have people with overall policy skills,” says course co-founder Garry Aslanyan, a Geneva-based adjunct professor at Dalla Lana. “And then you have the diplomats in the Canadian missions in Geneva or New York who understand that nothing is black and white when it comes to negotiating on the world stage.”

Training public health providers to understand the sensitivities and the political realities faced by diplomats or finance and trade ministers will help them give better, more successful advice to those officials, Aslanyan says.

Over many years working for NGOs, multilateral organizations and governments, Aslanyan often decried the opportunities lost when trade or aid deals were negotiated by people with no understanding of their ripple effects on public health.

Vaccines are a prime example, says Aslanyan. Sometimes, a deal is struck by G7 finance ministers to buy vaccines for low-income countries if pharmaceutical companies agree to make them. What follows is a complex dance of negotiations to ensure the right diseases are targeted, the best vaccines are created at affordable prices and in sufficient quantities – and trade benefits are distributed evenly. A health official in the Canadian government or an NGO who is able to understand and work across the different spheres will be more successful in shaping a deal that benefits public health. A similar drama is playing out now on the world stage as governments negotiate production of COVID-19 vaccines – a likely case study in the diplomacy course, Aslanyan says.

The course will delve into many real-world case studies. Students will “learn that negotiations around something like vaccine financing is actually contingent on many other factors that are not health related,” says Aslanyan. “You would need to understand how these seven countries work to make a deal while keeping that health goal in mind.”

The course will also cover diplomacy from an ethical and governance framework, with lectures by Dalla Lana Professors Ross Upshur and Jillian Kohler, who also serves as director of the WHO Collaborating Centre for Governance, Accountability, and Transparency in the Pharmaceutical Sector. Reflecting a key ambition of the Centre for Global Health, the course will serve as a hub for scholars, students and alumni to meet, collaborate and share ideas. 

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The politics behind how governments control coronavirus data – TheChronicleHerald.ca

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Anton Oleinik, Memorial University of Newfoundland

COVID-19 has affected almost every country around the globe. The World Health Organization has confirmed cases in 216 countries and territories, a total that represents more than 85 per cent of 251 entities recognized by the United Nations. Yet each government has responded differently to the coronavirus pandemic — including how data on the disease have been shared with each country’s citizens.

The selectiveness with which governments release information about the number of confirmed cases and the deaths caused by the coronavirus suggest techniques of “bio-power” may be at play.

French philosopher Michel Foucault invented the concept of bio-power in his lectures at the Collège de France in 1977-78. He defined bio-power as a “set of mechanisms through which the basic biological features of the human species became the object of a political strategy, of a general strategy of power.”

Foucault found an early example of bio-power in the smallpox vaccine developed by the end of the 18th century — one of the first attempts to manage populations in terms of the calculus of probabilities under the banner of public health. While a COVID-19 vaccine is still in the making, the concept of bio-power may help make better sense of how we see governments deal with the ongoing pandemic.

Our perception of the probability of contracting the virus and the chances to recover is shaped by the relevant statistical figures released by our respective governments. Those figures feed the entire spectrum of our own reactions to COVID-19 — including fear and negligence.

A balanced take on COVID-19 and a proper course of action to deal with the pandemic means the information provided by governments must be complete, valid and reliable. Unfortunately, that is not happening in many cases.

When examining how some countries have responded to the pandemic, bio-political factors should be taken into account. This includes how governments are collecting and sharing data about the coronavirus. Let’s look at three countries in particular.

The United States

In the U.S., COVID-19 information is disseminated by government agencies, universities, the media and even search engines. Various levels of governments remain the ultimate source of the reported figures, but how accurate are those figures?

The U.S. now has the most confirmed cases and deaths caused by COVID-19. While this can be explained by a late response to the pandemic and the lack of universal health care coverage, the political stakes in the COVID-19 crisis are also very high for the U.S.

The social and economic crisis caused by the pandemic will be a major factor in this year’s elections. In an effort to shift attention from his administration’s response, U.S. President Donald Trump has indicated China should be blamed for the crisis. The high number of infections and deaths contribute to a feeling of fear and insecurity — which from a bio-power perspective may actually help Trump sell his message.

Russia

In addition to being the only source of information about COVID-19, the Russian government also makes every effort to protect its monopoly on the production and dissemination of the relevant data. Anyone who attempts to collect and disseminate COVID-19 figures without having a “licence to inform” may face criminal charges for being an agent provocateur.

A group of medical doctors in Chechnya, the previously rebel region in the Caucasus now under the tight control of the central government, attempted to complain about the lack of preparedness to COVID-19. They were promptly accused of “provocations” and forced to deliver public apologies.

According to government data, Russia has one of the lowest COVID-19 mortality rates in the world, less than one per cent. (The U.S. reports a six per cent mortality rare; Italy, France and the U.K. are in the range of 14-15 per cent). Either the Russians have an exceptionally strong immune system or something is wrong with the way the government counts the deaths.

As well, the regular monthly statistics of deaths released by some regions shows an anomalous hike in April — numbers that are out of line with the officially approved figures of COVID-19-related deaths.

The gap between the number of officially acknowledged COVID-19 cases and deaths may have political explanations.

Similar to the U.S., the pandemic interferes with the political agenda in Russia. The constitutional referendum engineered to extend Vladimir Putin’s term as Russia’s president was originally scheduled on April 22, but was eventually postponed until July 1.

Putin is trying to make the gambit of accepting high (but not necessarily accurate) figures of COVID-19 infections and simultaneously doing everything possible to under-report the true number of COVID-19-related deaths. If successful, he would be able to claim credit for handling the crisis better than other world leaders.

Canada

Canada’s figures do not look controversial at first sight. The country has neither an exceptionally high number of COVID-19 cases nor an exceptionally high mortality rate (7.5 per cent). But that doesn’t mean there aren’t potentially some elements of bio-power at play.

Canada’s government chose to complicate the task of comparing the COVID-19 figures across its provinces and territories. The federal government’s website dedicated to COVID-19 reports the aggregate data only. No death statistics are included. Comparing the responses of each province requires an examination of 13 different provincial websites, which have various formats of reporting the relevant figures.

Access-to-information requests are not of great help here either, despite the fact that there are access-to-information acts both at the federal and provincial levels. It takes an average of one month to get a response to an access-to-information request under normal times. But now governments have full discretion in deciding what information on COVID-19 to release, as well as when and how to do it.

This means that in Canada, bio-politics manifests itself through the fuzziness of information and, in the absence of clear information, the public is expected to uncritically accept the actions of their governments.

The Conversation

Anton Oleinik, Professor of Sociology, Memorial University of Newfoundland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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China grows 'more assertive' in world politics as the U.S. leaves behind a vacuum, ex-diplomat says – CNBC

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China has been flexing its geopolitical muscles as countries around the world grapple with the coronavirus pandemic — a reflection of Beijing’s belief that “China’s time has come,” a former U.S. diplomat said on Thursday.

In addition to pressing ahead with a new national security law for Hong Kong, China has toughened its stance on Taiwan — which it considers a wayward province that must be reunited with the mainland. Beijing has also kept up its aggression in the disputed waters of South China Sea and recently, at its border with India.   

“China is being more assertive in pursuing goals that we know that it’s had in a number of decades,” Robert Daly, director of the Wilson Center’s Kissinger Institute on China and the United States, told CNBC’s “Street Signs Asia.”

“So clearly, this is an assertion of strength and it reflects a belief that China’s time has come, combined with the fact that this may be seen as a very good opportunity when America seems to have lost interest in global leadership and when there’s distraction from the coronavirus,” he added.

Chinese President Xi Jinping, also general secretary of the Communist Party of China Central Committee and chairman of the Central Military Commission, visits a commercial street in Xi’an, capital of northwest China’s Shaanxi Province, April 22, 2020.

Ju Peng | Xinhua News Agency | Getty Images

Daly worked at the U.S. embassy in Beijing in the late 1980s and early 1990s as a cultural exchange officer. He also served as an interpreter for both American and Chinese leaders, including former U.S. President Jimmy Carter and ex-Chinese President Jiang Zemin.

Geopolitical experts have said that China’s rise as a global power is a major contributor to tensions with the U.S. — the world’s largest economy that’s regarded as a global superpower and a world leader since World War II.

But the U.S. appears to have ceded much of its global leadership since President Donald Trump took office in January 2017. That has opened the door for China to pursue some of its long-standing geopolitical goals more aggressively, said Daly.

South China Sea, India

Beijing has not let the coronavirus pandemic affect some of its territorial pursuits.  

It has kept up its hostility in the South China Sea, in which it has overlapping territorial claims with multiple countries including the Philippines, Vietnam, Malaysia and Brunei.

Beijing claims nearly the entire resource-rich waterway, which is a vital commercial shipping route where trillions of dollars of world trade reportedly passed through.

Just last month, China’s relations with India also appeared to worsen when a military standoff started along the border they both share. Both sides blamed each other for initiating skirmishes which multiple reports said involved fist fights and stone-throwing, but the countries have since indicated their willingness to seek a diplomatic deescalation. 

Taiwan

At the same time, Beijing increased pressure on Taiwan with frequent military drills near the island, reported Reuters. China said those drills are routine, according to the report.

China claims the self-governed island of Taiwan as its own province which could be taken by force if necessary. Beijing has touted a “one country, two systems” model which it uses on Hong Kong, but that idea was not popular with Taiwan — and even less now after months of protests in Hong Kong.

Chinese Premier Li Keqiang said last week his country would “resolutely oppose and deter any separatist activities seeking Taiwan independence.” Li, the second-in-command, notably dropped the word “peaceful” when he referred to “reunification” with the island.

Hong Kong

Meanwhile, tensions have been reached fever pitch in Hong Kong as well.

The Chinese-ruled city was handed to China by the United Kingdom in 1997, and is governed under the “one country, two systems” principle which allows Hong Kong some freedoms that its mainland counterparts don’t enjoy. They include self-governing power, limited election rights, as well as a largely separate legal and economic framework from the mainland.

However, China pressed ahead to introduce a national security law in the city last week, essentially bypassing Hong Kong’s legislature

Critics see the proposed legislation as Beijing’s move to tighten its grip on the special administration region following months of pro-democracy protests that turned violent at times.  

Those issues that China has been pushing ahead with in recent months “aren’t new,” said Daly.

“What is new is them pursuing all of them with such vigor simultaneously,” he said. “And clearly they see vacuum and perhaps a lack of will from other nations, the United States in particular, to stand up for this.”

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