The US response to the COVID-19 pandemic is sporadic, uncoordinated and barely missing instructions from the US Centers for Disease Control and Prevention, a former agency director told the US TODAY.
And the “occasional” absence of the nation’s leading public health agency at the forefront of the coronavirus battle makes Tom Frieden feel “less secure.”
Now Frieden, a non-profit resolution to save lives, is advising other nations on issues related to the fight against epidemics. In his view, it is best practice in the world to appoint one case manager who reports to a health department official who then reports to the head of state.
That’s how it doesn’t work in the US.
“We have heard that FEMA is responsible. We have heard the Vice-President respond. We have heard that (US Ambassador) Dr. (Deborah) Birx is the coordinator. We have heard that (Health and Personnel Secretary Alex) Azar is in charge of the task force. Who’s here first? “Frieden told the US TODAY editorial about a video call.
One agency that is definitely not responsible is the CDC, which was headed by Frieden between 2009 and 2017.
It is a rough reversal of the past when the CDC not only took the lead in the United States but also globally against the threat of infectious disease. From the CDC SARS epidemic in 2002, the 2009 H1N1 influenza, the Ebola outbreak in 2014 and the Zika outbreak in 2015, the CDC held frequent and occasional daily briefings to the US government and beyond.
This time, however, the agency that has led all the major epidemic responses in the nation for the past seven decades is just not there, Frieden said. Its 700 professionals, with a special focus on infectious and pulmonary disease, are influencing the side.
“Fighting an epidemic without the CDC at the decision-making table and podium is like fighting with your back tied with your hand,” he said.
In earlier outbreaks, the CDC had often had daily calls with journalists. This time, the CDC has had several press conferences canceled “because if the White House has a press conference, they can’t have one,” Frieden said. CDC’s media page was last archived on March 9th.
Asked about Frieden’s comment, the CDC replied that it is still actively involved in the country’s COVID-19 response and is working with the entire federal government.
Robert Redfield, current director of the CDC, is a member of the White House Coronavirus Task Force, but has rarely appeared in almost daily video conferencing.
Why Tom Frieden disagrees with the Trump administration’s focus on high-performance coronavirus tests
In a wide-ranging debate, Frieden also told the editor about the coronavirus testing poorly.
According to him, the attempt to get every COVID-19 test tested everywhere is wrong for public health. In areas with multiple incidences, no one other than people who need to be hospitalized for a viral illness should be tested.
“There is no reason not to experience,” he said. “If you have mild symptoms, stay home!” Attempting to test means only using protective equipment, staff time, and scant test kits, and may contaminate others.
“If you’re positive, it doesn’t help to change anything. You will be allowed to stay at home unless you have difficulty breathing. Then you have to go to the hospital. “
However, in locations with relatively few COVID-19 cases, testing makes sense, Frieden said. In these areas, public health officials can monitor contacts, demand independence and slow down the spread of the disease.
He also disagreed that the Trump administration task force focuses on “high-performance” testing. Fast translation is what is needed, Frieden said.
“It may sound like a technical difference, but it’s a big difference,” he said.
High-performance testing requires the use of centralized laboratories, and results may take from one to four days. It’s useless for front-line medical professionals who see a large number of people in emergency rooms, he said. They need to know within one hour if there is a coronavirus and they should be released and quarantined.
And it will be even more important if, as Frieden predicted, a major wave of infections crashes into the United States.
“Seriously ill patients got infected 10-12 days ago. It takes about 10 days to get sick and five days to get very sick, ”he said. “Cases increase exponentially.”
It worries 35-year-old public health veteran. Decentralization of the US health system will only work if there is clear guidance from above, Frieden said.
“We can expect innovation and proactive action from states and local areas,” he said. “But we really need to have clear guidelines and coordination at federal level.”