Officials’ shiftiness in pandemic response fuels public confusion and concern

disinfectkellysikkema-300x201Because Covid-19 is caused by a novel coronavirus, the world has much to learn about it and its effects. For the voting and taxpaying public, a critical line of inquiry in the days ahead may be this: Why does this disease also seem to cause such an outbreak of shiftiness among our leaders?

Let’s start at the already beleaguered federal Centers for Disease Control and Prevention, once considered among the globe’s best agencies in handling infectious diseases.

Sure, the medical science changes by the day about Covid-19. But why did the agency set itself up for deserved criticism by changing, “without formal announcement or explanation,” its guidance about the infectiousness of “contaminated” surfaces and how the coronavirus spreads? That had been an issue of key concern for experts, who had cautioned the public for weeks now about hygiene and care in coming in contact with such areas. Instead, CDC officials tweaked the language on the agency web site, diminishing the risks. Maybe, they thought, well, that should do it.

It did not. Extremists saw this move as further evidence of conspiracies to hide truths about the coronavirus harms. Even experts were baffled, as the Washington Post reported, quoting Angela L. Rasmussen, a virologist at the Columbia University Mailman School of Public Health:

 “’A persistent problem in this pandemic has been lack of clear messaging from governmental leadership, and this is another unfortunate example of that trend,’ Rasmussen said. ‘It could even have a detrimental effect on hand hygiene and encourage complacency about physical distancing or other measures.’”

The CDC now cautions that the virus “spreads easily between people.” The web site says the coronavirus that causes the disease Covid-19, “is spreading very easily and sustainably between people.” But as the newspaper reported of what the CDC also says:

“‘The virus does not spread easily in other ways,’ the agency explains [and] touching contaminated objects or surfaces does not appear to be a significant mode of transmission. The same is true for exposure to infected animals.”

To be sure, officials have sought to drill down on their guidance about Covid-19 infectiousness, emphasizing its risks increase: in confined, indoor spaces; with greater and direct person-to-person contact, especially if they engage in activities that cause them to breathe deeper and expel more from their lungs; and if exposures last and have durations that are more than short and casual.

The CDC said it did not consider the changes it made to its web site to be major and officials emphasized that public health measures that have helped deal with the coronavirus should be sustained, including frequent hand washing, physical distancing, covering of the face, and staying home except for compelling reason.

Even as the agency was dealing with one Covid-19 contretemps, the CDC and several states were under heavy fire for what critics said was a simple — or duplicitous — data distortion.

Anger is growing that some officials have mixed numbers on two different kinds of coronavirus tests — a swab or spit version designed to detect if an individual is currently infected, and another that measures antibodies in the blood to see if a person has been exposed to or had the illness.

The comingling of results throws off experts’ ability to estimate how the pandemic is raging and who it affects and how. The mixed-up figures complicate efforts to calculate how deadly the illness is and its infectiousness.

Blending the two can inflate what politicians can tell constituents about the robustness with which coronavirus testing is occurring, allowing them to seem to be closing in on what has been much discussed as a central public health objective: increased testing. But as the Atlantic magazine reported:

“This [mixing] is not merely a technical error. States have set quantitative guidelines for reopening their economies based on these flawed data points. Several states — including Pennsylvania, the site of one of the country’s largest outbreaks, as well as Texas, Georgia, and Vermont — are blending the data in the same way. Virginia likewise mixed viral and antibody test results until last week, but it reversed course and the governor apologized for the practice after it was covered by the Richmond Times-Dispatch and The Atlantic. Maine similarly separated its data on Wednesday; Vermont authorities claimed they didn’t even know they were doing this. The widespread use of the practice means that it remains difficult to know exactly how much the country’s ability to test people who are actively sick with Covid-19 has improved. ‘You’ve got to be kidding me,’ Ashish Jha, the K. T. Li Professor of Global Health at Harvard and the director of the Harvard Global Health Institute, told us when we described what the CDC was doing. ‘How could the CDC make that mistake? This is a mess.’”

In Florida and Georgia, the Covid-19 test data is in even greater doubt.

Georgia Gov. Brian Kemp, who led the nation in relaxing tough public health measures designed to deal with the coronavirus, has defend his state’s bollixed up testing information as due to “incorrect sorting logic.”

Critics say the numbers he relied on were either dumb or deceitful, as a public health department chart showing coronavirus testing results were labeled as declining over time — even though they were presented in non-chronological order to make it appear that they were trending downwards when they were not.

Ron DeSantis, the Republican Florida governor and a darling of the White House for keeping open the state’s beaches during Spring Break and for easing his state’s stay-at-home orders early, has engaged in a raucous argument with the “chief architect” of his administration’s coronavirus web site.

She says she was fired when she refused to fudge data to make the state’s statistics look more favorable. DeSantis says that is untrue and that she is a disgruntled employee.

This staffing flareup, however, has kept in the Sunshine State’s headlines both how bungled the DeSantis administration’s response has been to Florida’s huge joblessness, as well as a donnybrook between media organizations and the state’s law enforcement agency. It oversees Florida’s medical examiners and has declined to fully disclose information about Covid-19 deaths as required under state law. It is difficult to determine the disease’s effects without seeing fully public health basics like mortality information, news organizations have insisted.

Questions aren’t swirling just around Covid-19 testing, either — they’re plentiful, too, in the area of the nation’s coronavirus vaccine development and the information-sharing with key lawmakers on Capitol Hill.

The New York Times reported that President Trump’s hand-picked leader of what the administration has termed its “warp speed” development of a coronavirus vaccine has “vast” and “intricate” connections in Big Pharma that critics say creates big conflict-of-interest issues.

The newspaper said Moncef Slaoui is a venture capitalist, a former and longtime executive at GlaxoSmithKline, and until recently a board member of Moderna, a Cambridge, Mass., biotechnology firm that has announced that results from tests on eight volunteers will allow it to pursue next steps in developing a Covid-19 vaccine.

The announcement of that preliminary finding, with limited information beyond, sent the Dow soaring for a day and Slaoui’s Moderna stock, with nearly $2.4 million, to $12.4 million, the newspaper said. He since has resigned from the company and has said he will donate his Moderna gains to charity.

But here’s the twist: He is not disclosing his complex and extensive holdings. Slaoui, 60, has flatly declined to divest his Glaxo shares, saying he was a career executive with the firm and sees his holdings in the firm as central to his retirement.

The administration has cut a deal with him, so he is officially a contractor, receiving $1 for his service. But as the newspaper reported:

“That leaves him exempt from federal disclosure rules that would require him to list his outside positions, stock holdings and other potential conflicts. And the contract position is not subject to the same conflict-of-interest laws and regulations that executive branch employees must follow.”

Ethics watchdogs find this set-up shaky at best, the newspaper said:

“’This is basically absurd,’ said Virginia Canter, who is chief ethics counsel for Citizens for Responsibility and Ethics in Washington. ‘It allows for no public scrutiny of his conflicts of interest. Ms. Canter also said federal law barred government contractors from supervising government employees.”

The administration, don’t forget, had a respected expert on vaccines and their development. But Rick Bright has been sidelined, and he has formally complained he has been demoted due to his opposition to Trump’s coronavirus responses, notably the push for the president’s much promoted use of antimalarial drugs. The research has not yet shown a clear benefit for use of hydroxychloroquine, while several studies have underscored its risks, particular in causing harms to the eyes and heart.

Ethics concerns during the pandemic, meantime, have not been limited to the administration. The U.S. Senate already has seen Sen. Richard Burr, the powerful Republican head of the Intelligence Committee, forced to recuse himself. An investigation is under way, digging into stock trades he and others, including his brother-in-law, made while Burr received confidential, high-level briefings about the spreading coronavirus outbreak in China and its potential global effects.

Kelly Loeffler, appointed by Gov. Brian Kemp to replace a retiring Georgia senator, also has been dogged by questions about her stock deals. She has denied any wrongdoing and said she will divest or her considerable holdings. She has said she has handed over documents to The Justice Department, the Securities and Exchange Commission, and the Senate Ethics Committee.

Her reelection campaign, however, has been struggling, and new questions have popped up because Loeffler’s husband, who is the chair of the New York Stock Exchange, has made a $1 million donation to the president’s reelection campaign. That has critics in a new tizzy, asking whether Trump loyalists, notably in the Justice Department, will go easy on Loeffler.

In my practice, I see not only the harms that patients suffer while seeking medical services, but also their struggles to access and afford safe, efficient, and excellent medical care. This has become an ordeal due to the skyrocketing cost, complexity, and uncertainty of treatments and prescription medications, too many of which turn out to be dangerous drugs.

Patients, in more normal times, have begged doctors, hospitals, and other parties in U.S. health care to make the system fairer, easier, and more open. Public health officials have underscored that people will help deal with pandemics only if the official responses are clear, cogent, transparent, and trustworthy.  We’ve got a lot of work to do in so many areas to get off shaky ground and on to a better place with this illness that has sickened millions, killed tens of thousands, and led to record joblessness and economic calamity.

Photo credit: Woman with cleaning products, @Kelly Sikkema, Unsplash
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