2. An early detection system of domestic and international public health threats is essential.
The COVID crisis has illustrated with full force and fury that we are a global community, but we must also act locally. The COVID virus was discovered in late 2019 in China, but allowing it to travel for weeks without tracing or examination was a gross error with serious consequences that impacted New York State and, by extension, our entire nation and the world. A recent study by the Icahn School of Medicine at Mount Sinai found that the virus was already spreading in New York in early February 2020, well before New York’s first official case on March 1, 2020. CDC reports in May and July confirmed the strain of the virus that spread in New York was from Europe, not China. The lack of an early detection system rendered New York effectively blind, because the erroneous information that the virus was still spreading from China led to the CDC’s early decision to reserve the nation’s limited testing capacity for travelers from China rather than Europe.
This initial error was compounded by the premature and ultimately wrong conclusion that COVID was transmitted by symptomatic and not asymptomatic individuals, which exponentially multiplied the number of people infected. This false premise was accepted early in the United States, even though doctors in Europe had publicly pronounced the possibility of asymptomatic spread as soon as the virus was detected. This warning was largely ignored.
An early detection system of domestic and international public health threats is essential for helping states fully understand the complexity of the threats posed by global pandemics and appropriately prepare. As we now look back, the lack of early warning detection as well as inaction by the federal government was a profound and deadly problem. A national security matter of this magnitude should not be left to the capacity and accountability of any international organization like the WHO. The United States must build our own capacity to adequately detect and understand the next global health crisis. This requires data and clear information to enable our government to make informed decisions. The more quality information we have, the better we will be able to respond to crises.
3. The leadership of public health organizations tasked to respond to future public health threats must be able to operate free from political interference.
COVID has shown us that political influence can have deadly consequences. While public health governance should have checks and balances, public health leaders—similar to other important positions in government—should be inoculated from political interference so they can express their expert advice without fear of political consequences. Public health leaders should require Senate confirmation and serve in term appointments so they are not subject to political interference by any president or federal administration.
Multiple media reports detail how during the COVID crisis Dr. Fauci, senior leadership at the CDC, and other federal health-care officials were censored by the Trump administration. The HHS secretary and the DHS secretary are presidential political appointees and too often appeared to be clearly charged with political spin over objective dissemination of information to the American people. In a public health emergency, it is paramount the public can trust the information they are receiving. If the American people are called on to take dramatic action, they will cooperate only to the extent they trust and respect the information and those providing it.
We do not need to create another bureaucracy, but we must ensure the competence and integrity of the ones that exist. We must drastically and quickly reform how our federal agencies operate. The CDC is currently a subdivision within the Department of Health and Human Services. HHS is an agency run by political appointees of the president, many of whom have no experience in anything related to health or human services. The CDC should not be a subdivision of an agency directly controlled by the president. In the meantime, Congress should fully investigate whether the CDC did not have the expertise and capacity to detect COVID or if the agency was suppressed in its attempts to communicate the depth of the crisis to the American people by the White House.
As of this writing, we do not know what the CDC and NIH knew about COVID and when they knew it. We do not know what the WHO informed the White House of and when. We do not know the source of information to the White House in January 2020 that led Peter Navarro, a senior aide to the president, to write a memo suggesting apocalyptic consequences from COVID-19. We must demand answers to these basic questions to understand why such an early warning by a senior administration official was ignored at the highest level of the federal government.
President Trump has blamed the World Health Organization for the lack of timely detection of COVID-19. However, the WHO did issue a global alert in late January—around the same time the president’s own senior aide raised a serious warning. Why then didn’t the United States act swiftly and deliberately to protect our citizens? An FDA press release on February 4 said, “At this time, federal health officials continue to believe that the threat to the general American population from this virus is relatively low.”
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