The CDC and COVID-19: Not ready a year ago, but too restrictive today?

In late 2019, I returned from a family vacation in Mexico and my wife became suddenly ill. She had a high fever, shortness of breath, fatigue and a cough; her eyes were clouded, and I thought it must be an atypical case of the flu. Despite studying influenza for many years, I had never seen a case like this one but I still gave her Tamiflu and she got better. 

It wasn’t until late February — when I visited the National Quarantine Center at the University of Nebraska Medical Center and interviewed patients from the Diamond Princess cruise ship (114 of 437 had tested positive for the SARS-COV-2 virus) — that I realized my wife might have been suffering from the same disease, even if I didn’t yet have the test to prove it.

This was the first lesson that the Centers for Disease Control and Prevention (CDC) and our health care system failed to incorporate into their responses to the new viral threat — namely, that this highly transmissible virus, often spreading asymptomatically, had spread into our communities long before we realized it and it needed to be responded to with a massive rapid-testing campaign. China, South Korea, Singapore, Australia and New Zealand all understood this, but we never did. In fact, the CDC continued to underestimate the threat throughout the early days of the pandemic. And our patchwork health care system was woefully unprepared. I remember thinking and saying that we had the greatest health care system in the world and it would rise to the challenge but the COVID-19 pandemic proved me wrong. In fact our hospitals have been so badly damaged by the pandemic that many rural and smaller regional hospitals have been struggling to stay open.

It wasn’t only the CDC that underreacted. Throughout January and February, the World Health Organization (WHO) repeatedly downplayed the risk and protected China’s interests at a time when the virus was spreading unchecked throughout Europe and the United States.

By the time the WHO was ready to call the coronavirus outbreak a pandemic on March 11, 2020, the virus had already spread to 114 countries, infected 118,000 people and 4,291 people had lost their lives. But the real numbers were actually far greater. COVID-19 was a pandemic long before this time, perhaps as early as January.

The CDC was slow to follow and endorse the emerging science on masks and even slower to acknowledge that schools were not places of significant spread, despite its own research papers which proved this. Its guidelines endorsed lockdowns with tortured, fear-halted reopenings, strangling our economy as well as our mental and physical health. 

We haven’t even begun to realize the extent of the damage from this. Fair Health just released an important study that reveals that mental health claims for the fragile and formative ages of 13 to 18 almost doubled in March and April 2020 when compared to the same months in the previous year. Fair Health analyzed more than 32 billion private health care claims and determined that intention to do self-harm, drug overdoses, anxiety and depression were all up close to 100 percent for these teens in the spring of 2020; self-harm claims were up more than 300 percent by August 2020. 

And then came the vaccines. History may remember the coronavirus vaccines in terms of almost military liberation from the pandemic, as well as the armamentarium for future pandemics — but, right now, the vaccine rollout as well as what to do when you have received one are submerged beneath excess guidelines.

Despite emerging research that demonstrates that the Pfizer, the Moderna and the Johnson & Johnson vaccines all markedly decrease transmission, CDC guidelines still heavily restrict who can receive a vaccine while also limiting what you can do once you’ve had one. I believe two shots of the Pfizer or Moderna, or one shot of the Johnson & Johnson, should be a ticket to the movies or to fly overseas, to go shopping or to the gym. These vaccines have far exceeded expectations and are, in fact, the ticket back to normal life.

One has to wonder if the CDC, so slow to react at the beginning of the pandemic, is now so fear-ridden as a result that it remains too reluctant to release the ties that bind us at the end. Once burned, twice shy, as they say. Of course these massive swings in policy are hardly the ideal way to pilot our public health ship through such treacherous waters as those of the past year.